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Print
out this form, complete as required and return with
payment to the address below: (Please make
checks payable to the PaceSetters, Inc.)
PaceSetters, Inc.
PO Box 681
Menasha, WI 54952-0681
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| Name: |
__________________________________________________________
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| Address: |
__________________________________________________________
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| City: |
_________________________ |
State:
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___________ |
ZIP:
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___________
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| Phone: |
____________________________ |
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| E-mail: |
____________________________ |
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Membership
status:
Membership
Level Desired - please check appropriate item:
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NEW |
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RENEWAL |
| Individual
Membership |
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1
year $20.00 |
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Lifetime
$150.00 |
| Family
Membership |
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1
year $35.00 |
Members
are asked to assist at least one event per year.
Please
indicate your choice below:
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Fun
Run/Walk(s) - 2nd Wednesday of each month |
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Run
for Home 5K & Youth Runs for Fitness - April
11, 2010 |
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PaceSetters
XC Run - August 4, 2010 |
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Cheesehead
1/2 Marathon & 5K Run/Walk - August 28, 2010 |
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St.
Joseph Food Pantry 5K Run/Walk - October 16, 2010 |
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Marathon/half marathon training runs (Held weekly May
– Sept) |
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Community First Fox Cities Marathon - September 17-19,
2010 |
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Thank You!
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