Northeast Ursamen Application

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Email *

First Name *

Last Name *

Full Legal Name *

Name you would like on your name tag *

Phone Number *

Birthday *

YYYY

Mailing Address *

City *

State *

Zip Code *

What is the best method of contact? *

Phone

Mail

T-Shirt Size *

Will you allow your pictures to be used on social media and/or for marketing purposes? *

Yes

We send 2 to 4 monthly emails and text messages. You may opt out of receiving text messages at any time after receiving the first message. *

I have read and understand the above statement.

By paying your dues, you agree to abide by the Bylaws, Code of Conduct, and Non-Discrimination Policy of the Northeast Ursamen, and you attest to being 21 years of age or older.

Dues Calculation:

1. The Club’s membership year is from October 1st to September 30th.

2. Dues for membership are calculated quarterly, starting at $40 and decreasing by $10 each quarter. A quarter spans 3 months.

3. New members pay dues based on the remaining months in the current membership year.

4. Joining in quarter 4 (July-September) requires an initial payment of $40.

5. This payment covers the remainder of the current membership year and the entire following year.

6. Members joining in quarter 4 do not need to renew their membership until the end of the subsequent membership year.

**Dues are subject to change at the discretion of the Board of Directors for a new membership year.

I have read and understand the above statement; I attest that I am at least 21-years of age or older; and I agree to abide by the Bylaws, Code of Conduct, and the Non-Discrimination Policy.

Membership Dues

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$20.00

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