Burleson Mounties Riding Club           

Member of District 10 of the National Association of Riding Clubs and Sheriffs Posses

 

Club Dues  $20.00/year per family     Association Dues  $35.00/year per family (optional)

 

 

Last Name: ________________________________

 

First Name: ________________________________             Date of Birth: _________________

 

Spouse�s Name: ____________________________              Date of Birth: _________________

 

Children:

 

Name: _______________________________           Date of Birth:_________________

 

Name: _______________________________           Date of Birth: _________________

 

Name: _______________________________           Date of Birth: _________________

 

Name: _______________________________           Date of Birth: _________________

 

 

Address: _________________________________________________

 

City:  __________________________  State: ______________   Zip Code: __________-______

 

 

 

Send dues to:

 

                        Vickey Sanders

                        8521 County Road 1004

                        Godley, TX 76044

                        817-309-2095

 

 

 

 

 

 

 

Date: ________________________________

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