Rupert Runners
Membership Application Form 2005
All members of Rupert Runners are required to join BC Athletics!
Please complete the BC Athletics Membership Form and
return it, together with this form and the appropriate remittance,
to Ray Leonard, 2150 Graham Ave, Prince Rupert, V8J 1C8. Make cheques payable to "Rupert Runners."
For details of membership types and benefits, please see the BC Athletics Form. Remittance should include the
appropriate BC Athletics fee plus $10.00 (Rupert Runners Fee). If you have any question, call Ray at 624-6336.
NAME ___________________________________________________________________ ADDRESS ________________________________________________________________ POSTAL CODE ______________ TELEPHONE ____________________ BIRTHDAY d____m____y____ SEX M F MEMBERSHIP TYPE:(check one) GENERAL MEMBERSHIP (includes BC Athletics "supporting membership" $20.00 ____ CLUB DIRECTORS (includes BC Athletics "associate membership" $35.00 ____ ATHLETE MEMBERSHIPS: JUNIOR DEVELOPMENT, JUVENILE, JUNIOR or SENIOR, (Serious athletes only - see BC Athletics form for fees) $ _________ ADULT RECREATION $45.00 ____ MASTER $50.00 ____
PDF version of the BC Athletic membership form:
http://www.bcathletics.org/main/pdf/indmemapp.pdf