Address: P.O. Box 9057

                                Pahrump, NV 89060

The benefit of membership is not having to pay a non-membership fee at each show.

Fees: Youth $5.00 Adult $10.00 Family $25.00

Name____________________________________________Enter Age if Minor________

Address__________________________________________Phone(____)____________

City_____________________________________State____________Zip____________

Email Address____________________________________________________________

Family Membership Information

(Family Membership Apply to 3 or more people in the same household.)

Name_____________________________________________Enter Age if Minor_______

Name_____________________________________________Enter Age if Minor_______

Name_____________________________________________Enter Age if Minor_______

Name_____________________________________________Enter Age if Minor_______

Name_____________________________________________Enter Age if Minor_______

NOTE: Membership does not become active until verification has been made by the secretary.

Adult Signature______________________________________________Date_________

Requires Parent or Guardian for Minors

For Office Use Only

Accepted by_______________________________________________Date__________________

Payment by_______________________________________Payment#______________

Amount_________________________________________________________________