UGRA Membership Application
Please complete this form and submit to Utah Gay Rodeo Association
A check or cash for you membership must be sent to:
Utah Gay Rodeo Association P.O. Box 702194 West Valley City, UT 84170
Or turned in to our Treasurer, Jim Baker.
We will be adding an online payment page shortly.
Email address *
Name *
Your answer
Name on membership badge
Please contact us at Secretary@UtahGayRodeo.com if you would like something other than your legal name printed on your membership badge.
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home/Cell Phone *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Would you like your personal information published in the membership directory? *
Type of membership *
UGRA Privacy Policy
UGRA does not give out our membership list to any organization. Member names may be published in our
newsletter and the membership directory. If you do not wish to have your name published, please notify the
board of directors in writing and we will attempt to accommodate your request.

By typing my name below, I confirm that I agree to follow the membership bylaws and standing rules as outlined by the UGRA.

Member Signature: *
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of UTAH GAY RODEO ASSOCIATION.