Membership information Form for Membership Account Creation
You are here because you decided to bypass our general registration subscription. What method did you decide to use to join club instead?
FIRST NAME
Your answer
LAST NAME
Your answer
Your Username you want to use for our membership login system (This can not be changed once it is set)
Do NOT put an email address in this space
Your answer
ADDRESS (Please enter full address, City, State, Zip)
Your answer
Phone Number
(best number to reach you at if we need to reach you) This is not published anywhere public
Your answer
How did you hear about us?
If a member referred you, what is the name of the member
Your answer
How many states do you have complete towards the 50 State Challenge you are working on?
You can send me this later if you still need to figure it out
Your answer
How Many official half marathons do you have finished toward the 100 Half Marathons Challenge? (if past 100, put total official half marathons)
You do not need to answer this if you haven't figured this out yet
Your answer
How many official half marathons and official full marathons total do you have complete toward the 500 Endurance Challenge?
You do not need to answer this if you haven't figured this out yet
Your answer
Birth Date (optional fo adults, but required for anyone under 18)
I like to have this for finisher history (but I don't publish it publicly)
Your answer
Email Address for all important notifications, correspondence and account login
This will be the email all important correspondence goes to and used for your member login. I do not spam our members with a zillion emails.
Your answer
For YOUTH Membership - Under Age 18 - Please list Adult Name Responsible for the Member under 18
If this does not apply to you, leave blank
Your answer
For YOUTH Membership - Under Age 18, if you listed the Youth's email above, please ALSO list the responsible adult's email address
Leave this blank if this you are not registering a youth member
Your answer
ONLY if you paid for the LIFE MEMBERSHIP, what shirt would you like?
You can choose Short Sleeve women's or men's tech shirt OR a Sleeveless technical Shirt. Shirts have map on back unless you specify different in note field below.
LIFE MEMBERSHIP MEMBERS: What color shirt did you want?
Life membership members, the shirt will have the map on back with challenges listed underneath. If you prefer the 100 half marathons back, please specify and I will let you know if I have your size and color in stock.
Your answer
ONLY If you paid for the LIFE MEMBERSHIP what color sticker woulld you like?
LEAVE THIS BLANK if you did not pay for the Life Membersip Option
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