White Mountain Milers
P.O. Box 1999 Conway NH 03818
*Membership 2017
First Name: __________________________________________
Last Name: ___________________________________________
Address: _____________________________________________
City: _____________________________________________State:_____________ Zip Code: _________________
Home Phone: ______________________________ Mobile: ____________________________________________
Email (print carefully!):
_____________________________________________________________________________________
DOB mm/dd/yyyy: ___________________________________ Gender: Female ______ Male _____
Check One:
Student: $5.00 _____ Individual: $10.00 _____ Family: $15.00 _____
If family, please list other members:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Make checks payable to: White Mountain Milers and send to the address listed at the top of the application form.
We are always in need of volunteers for various races. Please go to our web site www.whitemountainmilers.com to see the list of events where we can use your help.
* You can sign up to be a member on our web site if it is easier than this hard copy method.
Thank you and welcome to the club!