Jersey Sands Sled Dog Racing Association

Membership Application

Eligible persons and groups will become members upon receipt of dues. Dues are

payable on or before May 31^st of each year. If dues remain unpaid by June 30^th,

membership shall lapse. Dues received at any time of the year shall be applied to the

current membership year, except dues received during May, which may be applied

toward the following membership year.

Choose Membership Category:         o    Renewal           o    New Member

Choose Membership Type:

o Single Membership – Dues  $15.00 per year. Open to persons 18 years of age or older. Member may cast one vote, hold office, and participate in club functions.      

o Family Membership – Dues $20.00 per year. Open to family groups. Maximum of two votes per family group. Members may hold office (18 and older) and participate in club functions.

First Name: _________________________Last Name:_________________________

Address: _______________________________________________________________

City: ___________________ State: _______________Zip: ______________________

Home Telephone: _______________________ Cell Phone:_______________________

E-mail Address:__________________________________________________________

Name(s) of Family Members: ______________________________________________

Kennel Name: _________________________________ # Dogs in Kennel: __________

Breed(s) of Dogs:_____________________# Years in Dog-Powered Sports: ________

Any other dog related activities: ____________________________________________

________________________________________________________________________

May we share your e-mail, phone, city, and state with other members?  o Yes  o No

I agree to abide by the regulations of the Jersey Sands Sled Dog Racing Association as set forth by it’s officials, Board of Directors, and the By-Laws.

Signature: __________________________Date: _______________________________

                         Mail to:

Jersey Sands Sled Dog Racing Association

Jessica Keiner

 14 Waltham Dr.

 Tabernacle, NJ 08088