Adult Names 

Youth Names 

E-mail Address   Phone Number   Street Address

City   State   Zip Code

ARBA #   ARBA Expiration Date

TRBA Member Yes No   Expiration Date

Each Single: Youth $5.00 0 1 2 3 4 5 6 7 8 9 10   Adult $10.00 0 1 2 3 4 5 6 7 8 9 10   Family $15.00 0 1 2 3 4 5

*Please include all names of members, if there is no adult/youth member then put NO in the box. Remember, you won't be an official member until you have filled in all the values and your dues are received from the WTRCC secretary.

Send Dues To: Lisa Hall

              7677 Orchid Ave.

                San Angelo, TX 76901