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General Information
Name of University or College:
*
Name of Club:
Club website:
Club email:
*
Club logo:
Is the club currently recognized as a formal student org. by your institution?:
(Yes: No:)*
Is the club being funded by your institution? (Yes: No: )*
How much funding does the club receive?:
Would your club be interested in organizing and hosting an invitational open to other college running clubs in the area? :
(Yes: No:)
If yes, when?:
Contact Information
*Only email addresses are available to other clubs. All other contact info will be kept private.
If any contact changes occur please notify Membership Coordinator Julia Stulock immediately.
Club President:
*
Email:
*
Phone:
*
What will be his/her class standing for the fall of 2008?
*
Additional Officer:
Email:
What will be his/her class standing for the fall of 2008?
Summer Address: (to which info can be sent while school is not in session)
Name:
Street:
Apt:
City:
State:
Zip:
School Address: (to which info can be sent while school is in session)
Name:
Street:
Apt:
City:
State:
Zip:
Department contact information: (eg. club sports, campus rec, student activities)
Affiliated department:
Director:
Phone:
If there is another university or college that you think would be
interested in receiving information about NIRCA, please fill out the
following:
Name of University or College:
Name of Club:
Club Website:
E-mail:
There is no fee required to submit this application.
Application review typically takes one week.
Upon approval NO FEES are due until one year after initial membership. After that 1st year, a one-time $50 instatement fee is required, along with annual dues set at $100 per club for the 08-09 school year. Dues must be paid within 30 days of invoice receipt, membership is pending until received.
Membership Waiver
I acknowledge that it is my responsibility to understand the risks of competition and to determine whether I am, as well as my fellow club members, fit to safely compete in any NIRCA sanctioned events and will exercise any precautions that may be necessary to avoid injury. If injury does occur during competition the race’s organizers, hosts and sponsors will not be held liable. I also agree that my school’s organization will comply with all competition and non-discrimination guidelines set forth in the NIRCA constitution.
I accept the terms of this waiver and verify that the information provided in this application is accurate and
truthful to the best of my knowledge:
*
Position: