(844) MY-NWRBC - Membership Form 2016

MEMBERSHIP APPLICATION

ENDING DEC. 4th... JOIN NOW!!!

MEMBERSHIP YEARLY DUES:

ADDITIONAL ADULT $30

YOUR MEMBERSHIP INCLUDES YOUR CHOICE OF SHIRT STYLE ALONG WITH OUR NEW NORTHWEST RAIDERS PLASTIC LIFETIME CLUB CARD & NEW NORTHWEST RAIDERS CUSTOM MADE LANYARD.

NEED MORE GEAR??? PURCHASE AN EXTRA SHIRT...

--MUST BE A CURRENT CLUB MEMBER--

T-SHIRT, MUSCLE, TANK TOP $15

YOUTH CORE MEMBERSHIP Ages 8-15 $20

OUR YOUNG MEMBERSHIPS WILL GET THE NEW YOUTH SHIRT OR AN ADULT MEMBERSHIP SHIRT (DEPENDING ON SIZE OF THE KID), THE NEW NORTHWEST RAIDERS CUSTOM ITEM (TBA).

TODDLER MEMBERSHIP Ages INFANT-8 $10

FROM THE CRADLE TO THE GRAVE... START YOUR KID OFF RIGHT WITH A CUSTOMIZE NORTHWEST RAIDERS KID SHIRT. KEEP THE WHOLE FAMILY RAIDER STRONG.

NOTE: A PARENT MUST BE A MEMBER TO ORDER A KID'S CLUB SHIRT!!!

ARE YOU A PREVIOUS CLUB MEMBER AND CAN'T FIND YOUR MEMBERSHIP CARD?

**PLEASE COMPLETE FORM FROM A PC/MAC... MOBILE DEVICES MAY NOT PROCESS YOUR MEMBERSHIP FORM OR PAYMENT. **

ONCE YOU COMPLETE FILLING OUT THE MEMBERSHIP FORM, SCROLL ALL THE WAY TO THE END OF THE FORM AND HIT THE SEND BUTTON

IT WILL BE THE ABOVE THIS ICON


AT THIS TIME ALL PACKETS WILL BE MAILED TO YOU
PLEASE FILL OUT ALL INFORMATION
METHOD OF PAYMENT: PAYPAL (BELOW) CREDIT / DEBIT CARD (USE SQUARE LINK BELOW) CHECK /M.O. (FORM WON'T BE PROCESSED TIL RECEIVED)
MAIN ADULT NAME
FULL MAILING STREET ADDRESS
CITY, STATE & ZIP CODE
BIRTHDAY (ie. JAN 1, 1960)
MAIN ADULT CONTACT NUMBER:
MAIN ADULT E-MAIL ADDRESS:
MAIN ADULT SHIRT SIZE:
MAIN ADULT SHIRT STYLE: (Default Shirt is T-Shirt if none is selected)
WOULD YOU LIKE TO BUY AN EXTRA MEMBERSHIP SHIRT? PLEASE TYPE THE SIZE AND STYLE BELOW
WERE YOU A PAID CLUB MEMBER IN 2015? Yes No
WHAT YEAR DID YOU JOIN THE NWRBC (ie: 2006)? IF FIRST TIME TYPE "NEW"
HOW DID YOU FIND US / REFERRED BY?
SPOUSE / 2nd ADULT INFORMATION
SPOUSE FULL NAME
SPOUSE BIRTHDAY (ie. JAN. 1, 1960)
SPOUSE CONTACT NUMBER
SPOUSE EMAIL ADDRESS
SPOUSE SHIRT SIZE
SPOUSE SHIRT STYLE (IF NOT SELECTED DEFAULT IS ADULT T-SHIRT)
WOULD YOU LIKE TO BUY AN EXTRA MEMBERSHIP SHIRT? PLEASE TYPE THE SIZE AND STYLE BELOW
WAS SPOUSE A NWRBC MEMBER IN 2015? YES NO
WHAT YEAR DID YOU JOIN THE NWRBC (ie: 2006)? IF FIRST TIME TYPE "NEW"
CHILDREN MEMBERSHIP INFORMATION
KID #1 NAME
KID #1 TYPE BOY GIRL
KID #1 BIRTHDAY (ie. JAN 1, 1960)
KID #1 YOUTH OR TODDLER? TODDLER (AGES INFANT TO 8YO) $10 SHIRT ONLY YOUTH (AGES 9YO TO 15YO) $20 MEMBERSHIP PACKET
KID #1 SHIRT SIZE
KID #2 NAME
KID #2 TYPE BOY GIRL
KID #2 BIRTHDAY (ie. JAN. 1, 1960)
KID #2 YOUTH OR TODDLER? TODDLER (AGES INFANT TO 8YO) $10 SHIRT ONLY YOUTH (AGES 9YO-15YO) $20 MEMBERSHIP PACKET
KID #2 SIZE
KID #3 NAME
KID #3 TYPE BOY GIRL
KID #3 BIRTHDAY (ie. JAN. 1, 1960)
KID #3 YOUTH OR TODDLER? TODDLER (AGES INFANT TO 8YO) $10 SHIRT ONLY YOUTH (AGES 9YO-15YO) $20 MEMBERSHIP PACKET
KID #3 SIZE