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OHIO MINI REX
RABBIT CLUB MEMBERSHIP APPLICATION
DATE:________________________
NEW______________
RENEW______________
Please fill out form completely. A
phone number and / or e-mail address must be provided.
NAME:________________________________________________ ARBA#_______________
Open / Youth
NAME:___________________________________________________ ARBA#_______________
Open / Youth
NAME:___________________________________________________ ARBA#_______________
Open / Youth
NAME:___________________________________________________ ARBA#_______________
Open / Youth
NAME:___________________________________________________ ARBA#_______________
Open / Youth
ADDRESS:__________________________________________________________________________________
CITY:______________________________________________________
ST:________ ZIP:________________
PHONE:________________________
E-MAIL:____________________________________________________
RABBITRY
NAME:___________________________________________________________________________
YOUTH DATE OF BIRTH
(S):__________________________________________________________________
VARIETIES
RAISED:_________________________________________________________________________
Please circle your membership choice.
ONE YEAR DUES
ADULT:
INDIVIDUAL
$7
ADULT: COMBINATION
(H&W, or 2 adults living at the same address)
$10
FAMILY:
Husband & wife with
children
$15
YOUTH:
Under the age of 19
$5
3 YEAR MEMBERSHIP DUES:
ADULT:
INDIVIDUAL
$19
COMBINATION
$28
FAMILY
$42
YOUTH:
Under the age of 19 when 3rd year
expires
$12
I have enclosed $____
to join the OMRRC and agree to abide by
the constitution, bylaws, and club rules.
Mail completed form with payment to:
Amie Petras
304 Avon Belden Rd.
Avon Lake, OH 44012
apetey@lycos.com
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