Darkside Running Club Membership Application
Dues are based on the calendar year January 1st through December 31st.

Make checks payable to:  Darkside Running Club

Mail to:
Scott Ludwig
307 Haskin Knoll
Peachtree City, GA  30269


Name   _________________________________________________________

New Member_________________      Renewal___________________________

Address   _________________________________________________________

City ______________________ State__________  Zip_______________

Phone_______________________ Date of Birth______________________

E-mail_____________________________________________________________




(Signature)____________________________________________


(date)____________________________________