TRICLUB NEW MEXICO APPLICATION

Once again, please check the expiration date on your TRICLUB Card and renew if it is expired. If you don't have a card. please consider joining -Thanks.

Name:          

Address:       

City:              State: Zip:

Home phone: Work phone:

 

WAIVER-Please read before signing: I hereby for myself, my heirs, executors and administrators waive and release TRICLUB New Mexico, its directors, volunteers, agents and sponsors to the rights to any claims resulting from injury, property damage,theft or even death, resulting from any club related event or training activity.

Print name Signature ________________________ Date


Membership Fees:

Single $8.00 Family $12.00


You may fill in this application, then print and sign it.

Please return the signed application with payment to:
TRICLUB New Mexico
1612 Lafayette Dr. NE
 Albuquerque, NM   87106