LightSpeed Running
Guest Pass Application

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NAME:                                                                                                DATE:                                     

ADDRESS:                                                                                                                                          

CITY/STATE/ZIP:                                                                                                                             

HOME PHONE:                                                          WORK PHONE                                                    

E-MAIL:                                                                                                                                             

DATE OF BIRTH:                                                       GENDER                                                            

HOW DID YOU LEARN ABOUT LIGHTSPEED RUNNING?                                                                                 

                                                                                                                                                             

                                                                                                                                                             

DO YOU BELONG TO ANY RUNNING OR TRACK CLUB?                                  

IF SO, WHICH ONES?                                                                                                                          

                                                                                                                                                                                                      

                                                                                                                                                                                                      

AT WHAT DISTANCES DO YOU NOW COMPETE?                                                                                

My signature below confirms my desire to practice with LightSpeed Running.  As a guest of the running club, I acknowledge that training for and competing in track and field events can be an extreme test of a person’s physical and mental abilities and is potentially hazardous.  I hereby assume all risk associated with my participation in any activities organized by LightSpeed Running and its members.  I certify that I am physically fit and have not been advised against strenuous physical activity by a physician.  I further affirm that I have read this entire application and understand its contents.

 

 

Print Name:                                                                                                                                          

Print Date:                                                                                                                                           

Signature:                                                                                                                                            

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©2005 LSR, Inc.