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GCGRA Inc
Gold Coast Gay Rodeo Association
PO Box 7254
Jupiter, Fl 33468
Member Information
Type of membership?
*
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New Member
Renewing Member
Name of
Primary
Member:
Please be aware that documentation verifying your tax-deductible donation to GCGRA, Inc. will only be in the name of the Primary Member. *Once 501c(3) status has been obtained!
First Name
*
Last Name
*
Street Address
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Apartment, Unit or Suite
City
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County
*
State
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Postal Code
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Primary Phone
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Alternate Phone
Email Address
*
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Standard Memberships
Standard Memberships:
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Single
Family
Business
Clear Selection
New Single Member Fee:
*
🛈
Single New $25
New Family Member Fee:
*
🛈
Family New $40
New Business Member Fee:
*
🛈
Business New $75
Renewal Single Member Fee:
*
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Single Renewal $25
Renewal Family Member Fee:
*
🛈
Family Renewal $40
New Business Member Fee:
*
🛈
Business Renewal $75
Additional family member information
Name of Family Member [First & Last Name]:
*
Email Address
*
Premium (Founder) Memberships
Premium Memberships:
*
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Single
Family
Business
Clear Selection
New Single Member Fee:
*
🛈
Single New $100
Renewal Single Member Fee:
*
🛈
Single Renewal $100
New Family Member Fee:
*
🛈
Family New $150
Renewal Family Member Fee:
*
🛈
Family Renewal $150
New Business Member Fee:
*
🛈
Business New $250
Renewal Business Member Fee:
*
🛈
Business Renewal $250
Additional family member information
Name of Family Member [First & Last Name]:
*
Email Address
*
Name Badge
Would you like a name badge ($5 per badge fee)?
*
Yes (Name Badge)
No
Name Desired for Badge 1:
*
Family Name Badges
Would you like a name badge ($5 per badge fee)?
*
Yes (Name Badge)
No
Name Desired for Badge 1:
*
Name Desired for Badge 2:
*
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