MEMBERSHIP INFO

CLUB (FAMILY) MEMBERSHIP IS $25.00 PER YEAR.  18 YEARS OR OLDER.

MEMBERSHIPS RUN FROM SEPT 30 FOR 1 YEAR

PLEASE PRINT OUT THE FORM BELOW AND FILL OUT, INCLUDE YOUR $25.00, AND MAIL TO:

TIM VIOLA, PO BOX 171, CHASSELL, MI 49916

PLEASE PRINT CLEARLY

ANNUAL ($25.00) ___________    OR RENEWAL ($25.00) _______________  CHECK ONE

NAME_________________________________________________ DATE _____/_____/_____

MAILING ADDRESS ____________________________________________________________

CITY________________________________________________ STATE__________________

PHONE (_______)________-__________________________  ZIP_______________________

DATE OF BIRTH ______-______-______  

WOULD YOU LIKE YOUR NEWSLETTER SENT BY: MAIL__________  INTERNET ____________

IF YOU CHOSE INTERNET, YOUR E-MAIL ADDRESS:___________________________________