Date of Birth
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If this is a family membership, please list the
name, gender, date of birth and, optionally, email address, for each additional club member. Use the "Additional Names" link as necessary to create a new field for each individual.
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Carolina Godiva Track Club will only use your email address to send you the monthly newsletter and occasional club announcements. You may unsubscribe at any time.
As a safety precaution, we like to know who among us might be available to help out if a medical problem happens at one of events, and some of our races require that we have licensed medical personnel on hand.
Please check if you are a(n):
I'm willing to be a medical volunteer at Godiva events PayPal Email Address
If you plan to submit a PayPal payment, please use the field below to provide the email address associated with your PayPal account, particularly if that address is different from the one provided above, so that we can properly credit the payment to your application.
Waiver, Release, and Indemnity Agreement Please read the waiver carefully.
I know that running and volunteering to work in club races are potentially hazardous activities. I should not enter and run in club activities unless I am medically able and properly trained., I agree to abide by any decision of a race official relating to my ability to safely complete the run. I assume all risks associated with running and volunteering to work in club races or events, including, but not limited to, falls, contact with other participants, the effects of the weather, includinghigh heat and/or humidity, the conditions of the road and traffic on the course, all such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration of your acceptance of my application for membership, I, for myself and anyone entitled to act on my behalf, waive and release the Road Runners Club of America, The Carolina Godiva Track Club, all officers, directors, sponsors, volunteers, their respectives and successors from all claims or liabilities of any kind arising out of my participation in these club activities even though the liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Further, I agree, for myself and anyone entitled to act on my behalf, to hold harmless and indemnify any of the persons or entities mentioned above from all liability, legal, actions, debts, claims, and demands of every nature which arise out of Carolina Godiva Track Club activities. Finally, I grant permission to Carolina Godiva Track Club to use photographs, motion pictures, videos, or any other records of club activities showing my image or likeness, for any legitimate purpose.
You must be over 18 years of age OR the parent/legal guardian of a minor under 18 years of age in order to agree to the terms of the waiver.
I consent to the waiver. By entering my intials in the box below, I electronically sign my acceptance of this waiver.