DDRC Membership Application

 

Membership Renewal/Application Form and Waiver

 

Print this form and mail with payment to:

 

DDRC Membership

C/O Barb Dubovski

4205 Grandbrook Ln

Plano, TX 75074

 

Please Print:

 

Name:________________________________________________________

 

Street_________________________________________Apt. No.:________

 

City:_______________________________State:_______Zip____________

 

Telephone:� Home (_____) _____-_______ Work (_____) _____-_______

 

Email address: ______________________@_________________________

You must have an E-Mail Address to receive the monthly newsletter.

 

Type of Membership: _____Individual; _____Family (cost is the same)

 

Term of Membership:� All memberships expire on December 31^st.

All renewals are $20.00 regardless of month of renewal.

 

I have read theWARNINGS AND LIABILITY LIMITS WAIVER found on the website. 

 I understand it and I agree with it as a condition of membership in the Dallas DownRiver Club.

 

Signature:_______________________________________Date:______________

 

�(Family memberships-all participants 13 years and above must sign waiver.)

________Check if all other family members are less than 13 years of age.

 

Check all that apply.

 

_____$20.00  $________  for individual membership renewal  

_____$30.00  $________  for family membership renewal         

_____$20.00  $________  for New Single Membership     

_____$30.00  $________  for New Family Membership 

   Total           $_________

 

 

No.:______________________________________________________