(844) MY-NWRBC - Membership Sign Up


PLEASE FILL OUT ALL INFORMATION
DATE OF YOUR FILING
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:
WOULD YOU LIKE TO BUY AN EXTRA MEMBERSHIP SHIRT? PLEASE TYPE THE SIZE AND STYLE BELOW
WERE YOU A PAID CLUB MEMBER IN 2017? Yes No
WHAT YEAR DID YOU JOIN THE NWRBC (ie: 2006)? IF FIRST TIME TYPE "NEW"
HOW DID YOU FIND US / REFERRED BY?
EARLY MEMBERSHIP DRIVE: PICK UP SCHEDULE FOR JULY 8th AT THE SUMMER BBQ. IF NOT , SELECT SHIPPING AND BE SURE YOU CHOICE EITHER ONE OR MORE PACKETS. WILL PICK UP AT THE SUMMER BBQ NEED MY ONE PACKET SHIPPED TO ME ($5-SHIPPING) NEED MY MULTI PACKETS SHIPPED TO ME ($10-SHIPPING
SPOUSE / 2nd ADULT INFORMATION
SPOUSE FULL NAME
SPOUSE BIRTHDAY (ie. JAN. 1, 1960)
SPOUSE CONTACT NUMBER
SPOUSE EMAIL ADDRESS
SPOUSE SHIRT SIZE
WOULD YOU LIKE TO BUY AN EXTRA MEMBERSHIP SHIRT? PLEASE TYPE THE SIZE AND STYLE BELOW
WAS 2nd ADULT / SPOUSE A NWRBC MEMBER IN 2017? YES NO
WHAT YEAR DID YOU JOIN THE NWRBC (ie: 2006)? IF FIRST TIME TYPE "NEW"
CHILDREN MEMBERSHIP INFORMATION
KID #1 NAME
KID #1 BIRTHDAY (ie. JAN 1, 1960)
KID #1 YOUTH OR TODDLER? NONE TODDLER (AGES INFANT TO 5YO) $10 SHIRT ONLY YOUTH (AGES 6YO TO 15YO) $20 MEMBERSHIP PACKET
KID #1 SHIRT SIZE
KID #2 NAME
KID #2 BIRTHDAY (ie. JAN. 1, 1960)
KID #2 YOUTH OR TODDLER? NONE TODDLER (AGES INFANT TO 5YO) $10 SHIRT ONLY YOUTH (AGES 6YO-15YO) $20 MEMBERSHIP SHIRT
KID #2 SIZE
KID #3 NAME
KID #3 BIRTHDAY (ie. JAN. 1, 1960)
KID #3 YOUTH OR TODDLER? NONE TODDLER (AGES INFANT TO 5YO) $10 SHIRT ONLY YOUTH (AGES 6YO-15YO) $20 MEMBERSHIP SHIRT
KID #3 SIZE

(SELECT ALL THAT APPLIES):


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Comments:

UPDATED: SUNDAY JUNE 10, 2018

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