New____ Renewal____
Individual $10___ Household $15_____July 1 through June 30 (Full Year), or,
Individual $5___ Household $7.50____ January 1 through June 30 (Partial Year)
Name(s)
Household membership; List all members
Address
City, State, Zip
Day phone Eve phone Cell phone
E-mail address
Our membership list and contact information is distributed to our members, but not outside of the organization. If you wish to have your information withheld from distribution, please so indicate below.
Check the box below for information you DO NOT want made available to fellow members.
All info, including name ________
Address_______ Email address_______ Phone(home)_______ Phone(cell)_________
Your active participation is important.
Please circle at least one area of interest:
Checkpoints Publicity
Serving food Registration
Mailing Telephoning
Trailblazing Awards
Make checks payable to:
First Coast Trail Forgers Walking Club
c/o Kristin Raasch