|
MRCA
20____ Membership Application
All Contesting Members Must Be Missouri Residents
Enclosed
is $85.00 for contestant membership or $55.00 for a personnel card to
the Missouri Rodeo Cowboy Association, Inc. Also available is a $25
“Associate Membership” for keeping in touch with the MRCA. Memberships
become delinquent after December 31st.
All membership cards must be purchased by June 15 to be eligible for the
current year finals.
Return this form to: MRCA Secretary ~ Rural Route
2, Box 254, Adrian, MO 64720-9471
Check all that apply:
Contestant
£
Personnel
£
New £
Renewal
£
Gold Card Member
£
Please Print:
Card Number_______________
Name
Address
County
City
State Zip
Phone
Email
Birth Date
Circle Jacket Size XS S M L
XL XXL XXXL
Circle event:
BB SB BR CR O40CR
SW GBR TR header TR
heeler BKWY
Circle Personnel Category:
Announcer Secretary
Timer Judge
P/U Man Bullfighter
Other
Associate Membership:
£
(Does
not allow any benefits for awards or hire at any MRCA event.)
Payment
£
Cash
£
Check
£
Money Order Total
Paid:
A $5.00 service
charge will be added to all payments made by Credit Card. Include
all charges in your total paid balance.
£
Visa
£
Mastercard
£
Discover Card No:
Expiration
Date:
Name as on the Card:
Cardholder Signature:
MO Drivers License
No.
MUST Be Provided in Order to Issue a Contestant Card
Signature
I certify the above information to be
correct, as a member of the MRCA, I agree to abide by all rules, by-laws
and regulations at all MRCA sanctioned and co-sanctioned events. I will
not hold the MRCA or any of its affiliates liable for property damage or
injury.
All Applicants under 21 years
of age must complete the following. This must be notarized and
returned to the MRCA.
Notary Public Date
My commission expires
|