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Online registration for this Event is scheduled to be open through Monday September 30th, 2019 - Midnight (USCT). To register for this event please complete the form and click the Continue button below.
Race Information
Race Name:2019 Prairie State Road Runners Membership
Location:Will County, Illinois
State:Illinois, United States
Posted:October 2nd, 2018 9:39 am
 
Race: Logo
Event Information
Name of Event:2019 PSRR Family Membership Application
Distance:1.00
Measurement:Years
Date:Tuesday December 31st, 2019
Start Time:12:00 am
Special Instructions:
Family Membership
Event Registration Schedule
Opened:Sunday October 21st, 2018Start of Day
Deadline passed:Monday December 31st, 2018Midnight $20.00
Register by:Monday September 30th, 2019Midnight $25.00
Unless otherwise noted... Registration Dates & Times are based upon: U.S. Central Daylight Saving Time
 
This race features 4 events. Please checkmark to verify your registration intentions for:
2019 PSRR Family Membership Application 1 Years
To choose a different registration, click its name below:
2019 PSRR Individual Membership Application • 1 Years
2019 PSRR Student Membership Application • 1 Years
2019 PSRR Hall of Fame Special Membership • 1 Years
Step 1 of 2 - Family Membership Application
Primary Member's First Name
 
Last Name
Address 1
Address 2
City
State / Province
Use 2 digit code for US and Canada
otherwise, leave blank.
[US Flag]  [Canadian Flags]
Country, if outside of the U.S. and Canada
Leave blank if address is in US or Canada.
Zip / Postal Code
Primary Member's Phone Number
Required... please provide your primary phone number.
Other Phone
Optional... provide an alternate phone number.
Primary Member's Email Address
Your active Email Address... please check for accuracy.
Primary Member's Date of Birth
Sex
M for Male, F for Female.

Special Class: Year that You Joined PSRR Club?
Required... please enter the Year (or approximate Year) that you originally joined the Prairie State Runners Club.

How did you hear about Prairie State Road Runners?
Optional... help make our club better by letting us know how you found us.

Total Number of Members for Your Family (2 minimum to 6 maximum)
Total number of members for your family... you plus the number of your family members.
Example... Let's say your family is made up of you, your spouse, and two children.
You + Spouse + 2 = 4

Waiver
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 relative to my ability to safely complete the run. I assume all the risks associated with running and volunteering to work in club races including, but not limited to falls, contact with other participants, the effects of the weather, including high 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 Prairie State Road Runners and all sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in these club activities even though that liability may arise out of negligence or carelessness on the part of
the persons named in this waiver.
 Agree to waiver by checking here.
By agreeing to this waiver you submit to the terms and conditions as set forth by this event and certify that you have provided true and accurate information as requested through this registration process.
Enter additional Family Member(s) below. Do not re-enter Primary Member!
Additional
Family
Member
First NameLast NameAge in
Calendar Year
Date of Birth
Format: YYYY-MM-DD
SexEmail Address
1:
2:
3:
4:
5:

Confirm your responses above... then click Continue to advance to Step 2.
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