Pacific Strider
Membership Application

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Dues paid after October 1 include membership the following calender year.
Members are encouraged to join the PAUSATF (Club #220) at www.pausatf.org

Send check made payable to Pacific Striders with a filled out copy of this form to:

Tim Keenan 1200 Newell Hill Place, #202 Walnut Creek, CA 94596

• If you are already a member and just ordering a singlet, please just fill in the necessary information.
• Add $1 extra if you want it mailed, otherwise you will have to pick it up at a track workout, Sunday run or PAUSATF race.
• If you plan to compete for the club at PAUSATF races, please remember to get your PAUSATF Card at https://www.usatf.org/membership/application/

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NAME ____________________________________________________

ADDRESS _________________________________________________

CITY ___________________________ STATE _____ ZIP __________

PHONE NUMBER (____) ____________________________________

EMAIL ADDRESS __________________________________________

RUNNING EXPERIENCE/10K PR ____________________________

_________________________________________________________

AGE ______ D.O.B. ________

RACING INTERESTS: Road, Cross Country, Ultramarathons, Track

Are you a PAUSATF member for the current year? Yes No Plan to join

SELECT ONE :

Join Pacific Striders - Without Singlet ($20)
Join Pacific Striders - With Singlet ($30) New Members Only
I am already a member and just want to buy a singlet ($20)

Singlet size: MENS -S, M, L, XL - or - WOMENS: S, M, L

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updated 1/15/07