Full Membership Form Credit Card Payment

* For initiation fee and stock holding members paying by credit card ONLY
* A 3% fee is added to cover credit card costs
* Please complete form and PRINT for your records BEFORE clicking submit .

      
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
2016 Membership Registration
Adult Member Name *
First Last
E-mail *
2nd Adult Member Name
First Last
2nd E-mail
Phone: *
- 
Area Code Phone Number
Address *
Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip Code
Occupation: 
type_submit_reset_55 
Clicking the Submit button will take you to Paypal
Complete payment with credit card or Paypal
You do NOT need a Paypal account to pay by credit card
Membership type - select one: *
Family Membership $716
Couples Member $500
Individual Member $371
Emeritus Family (13 yr+) $613
Social (Party) Membership - $77
Inactive Membership $25
Quantity
Child Name:(1)
First Last
Birth Date (1):
 /   /  
day month year
Child Name:(2)
First Last
Birth Date:(2)
 /   /  
day month year
Child Name:(3)
First Last
Birth Date:(3)
 /   /  
day month year
Child Name:(4)
First Last
Birth Date:(4)
 /   /  
day month year
Emergency contact Name and phone
Comments