| Bummercars.com MEMBERSHIP FORM Please print form, fill out and send along with a picture of you and your vehicle to: Ryan Van Kleeck, 119 Sawkill Rd, Kingston, NY 12401 or email info to: REDROCKETCLUB@aol.com |
| NAME:_________________________________________________ |
| Address:_____________________________________________ _____________________________________________________ |
| DOB:________________________ |
| E-MAIL ADDRESS:_____________________________________ |
| How did you find out about the RED ROCKET CLUB? circle which apply word of mouth website friend family Ryan V. other:_____________________________________________________ __________________________________________________________ __________________________________________________________ |
| SHIRT SIZE: Lg. or XL. -Free while supplies last! |
| Free video Selection: Fran's wedding video, choose 1! the 3rd annual camping trip RRC CRibs: James Byrne COUNTRYTIME Mary Van Kleeck's 80th b-day Barry Creagan's graduation RRC SKI TRIP Southfield Street Cafe' The Kingston A-team intro |
| nick name:_________________________ |
| home phone number:______________________ |
| would you like to be a RRC big Dogg? yes / no |
| if you answered yes to the last question... what position would you like? ________________________________ |
| what is your favorite website?______________________________ |
| what is your favorite resturant?___________________________________ |
| make / model & year of your vehicle (s) ________________________ ________________________ _________________________ |
| nickname you call your vehicle (s) _____________________________ ______________________________ ______________________________ |