Southern Indiana Racewalkers Membership Application
Name:
Mailing Address Line 1:
Mailing Address Line 2:
City:
State/Provence:
Country: Postal/Zip Code:
Email:
Membership Type
Individual Membership $15 (Local) Family $20 (Local) Individual $10 (Non Local) Family $15.00 (Non Local)
Please send check or MO to:
SIRW 515 E. Jennings St. Newburgh, IN 47630
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