Membership Renewal
 50 States Marathon Club
PO Box 15638
Houston, TX  77220-5638

Name __________________________________  Date of birth ____________________
Address ________________________________________              Sex (M/F)  ________   
City _______________________________ State_________ Zip Code ______________
Home phone _______________________   Other  phone _________________________
Email address __________________________________________________________
Occupation (or retired from)  ________________________________________________

Okay to list email on web site? Y/N  ____       Okay to list state on web site? Y/N   ____
You may pay your dues in advance for the next few years if you would like.
_____  Annual dues    (1 yr = $10, 2 yr = $20, 3 yr = $30, etc.)                                    
_____  Donation                                              
_____  Total   (due by 5/31/10)   
Make check payable to: 50 States Marathon Club

Marathons completed           ______                     Continents completed                 _______
Ultras completed                    ______                     Canadian provinces completed _______
Total marathons/ultras          ______                     Non USA countries completed  _______
States completed                  ______   for the 1^st, 2^nd,3^rd,4^th, time (circle)     
                                                                        
Finishers
Complete this section if you have completed the states, the continents, Canada and/or Australia

Date and location of completion of ALL 50 US states
1^st time __________________________ 2^nd time ______________________________
3^rd time __________________________ 4^th time ______________________________
Additional times ________________________________________________________

Date and location of completion of ALL 7 continents
1^st time _______________________________________________________________
Additional times ________________________________________________________

Date and location of completion of ALL 13 Canadian provinces & territories
1^st time _______________________________________________________________
Additional times ________________________________________________________

Date and location of completion of ALL 8 Australian states & territories
1^st time _______________________________________________________________
Additional times ________________________________________________________





Questions are changed each year and the answers are used in our newsletter

Personal Profile for ___________________________ (name) __________ (date)

Years marathoning   __________                                          Age at your first marathon   __________

Goals for 2010/2011 ___________________________________________________________________

What other hobbies and interests do you have besides marathoning?
____________________________________________________________________________________

Do you cross train?  Yes / No   If yes, how and how often? 
_______________________________________________________________________________________________

Do your family members marathon?  Yes / No  Are any of them 50 Staters?  Yes / No  If yes, who and how are you related?
_____________________________________________________________________________________

Who do you train with? _________________________  Who do you marathon with?___________________

Have you ever had a running injury?  Y/N If yes, please tell how you recovered.
____________________________________________________________________________________

What is the best finisher medal/award you have received? ____________________________________________________________________________________

What music (if any) do you listen to while you run/train/marathon?
_______________________________________________________________________________________________

What marathon athlete do you admire and why?
_____________________________________________________________________________________

What items are absolutely necessary for you to have with you when you marathon?
_____________________________________________________________________________________

What important item have forgotten to take and had to borrow or buy at the last minute?
_____________________________________________________________________________________ 

Do you take/use a cell phone while marathoning?  Y/N  Why/why not?
_____________________________________________________________________________________

Have you ever forgotten to register for a race, reserve a car, hotel, etc.?  Y/N  What did you do about it?
____________________________________________________________________________________

Personal Bests (PB or PR):
Marathon __________________________________ finish time_______________ date______________
Ultra ______________________________________finish time________________date______________

Personal Worsts (PW):
Marathon __________________________________ finish time_______________ date______________
Ultra ______________________________________finish time________________date______________

Please return profile to:  50 States Marathon Club, PO Box 15638, Houston, TX 77220-5638