PRINT
Portland Masters Membership Form
Membership fee: $30 single / $40 couple
Name(s)
Address
Email(s)
Phone(s)
Birth Date(s)
Events
Sprints
Hurdles
Middle
Distance
Distance
Race Walk
Throws
Jumps
Multi-
Events
Sprints
Hurdles
Middle
Distance
Distance
Race Walk
Throws
Jumps
Multi-
Events
New Member
T-shirt
S
M
L
XL
XXL
S
M
L
XL
XXL
Other
Participation
Interests
Serving on
Committee
Officiating
Helping
at Meets
Board
Member
Serving on
Committee
Officiating
Helping
at Meets
Board
Member
Mail to (w/check payable to Portland Masters Track Club):
Richard Ying (ph: 360-834-3452)
PMTC Membership Chair
1635 NW Deerfern St.
Camas, WA 98607