SoCal Ultrarunners Grand Prix Series Membership Application for 2010

Name:
Address:
City:
State:
Zipcode:
Phone:
Email:
Age on January 1st, 2010:
Date of Birth:
Gender:	Male
	Female
Membership:	New
	Renewing
First Year Joined:
USATF Member? (Yes or No)
USATF Number for 2010
Races completed in 2010

Be sure to include a $25 check and make payable to SoCal GPS

Mail to:
SoCal GPS
c/o Joe Magruder
14 Somerset
Dove Canyon, CA 92679