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Name____________________________________________________

(Check one) Male____ (or) Female_____ (or) Family______

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Date of Membership_______/_______/___________

Mail with check for $10 Online $15.00 for direct mail to:
Julie Shaver
Galesburg Road Runners Club Secretary
Post Office Box 594
Galesburg, Illinois 61402-0594

  • By David Shaver at 2009-08-18 05:54
  • ""

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