legends_club

Name:___________________________________________________________________________________

Address:_________________________________________________________________________________

City:__________________________State: ______ Zip: ___________Country:________________________

Phone #: ___________________________ Email Address:_______________________________________

How many marathons / half marathons / ultras have you run? ___________

What date did you finish your 100th marathon / ultra or Half marathon series in one calendar

year________________________________________

Gender: Male ______ Female ______

Birth Date________________________________

T-Shirt Size: Small ______ Medium ______ Large ______ X-Large ______

Signature of athlete _______________ Date _____________________________________

Signature of parent/guardian under age of 18 _________________Date________________

Note:
The applicant must be approved by a unanimous vote of the Board of Directors. All fees are none refundable after approval.
The member must pay a one-time membership fee of $100 USD. In addition, the member must pay a $20 USD annual fee.