DTx Membership Application Form

Date ________________

Last name _______________________________________ First Name ________________________

Address __________________________________________________________________________

City ______________________________________ State _________ Zip __________ - __________

E-mail address _________________________________________

Telephone ______ -________ - ___________ Date of Birth _____ /_______ / _______

Type of Membership: Check Next to type of membership you would like.

____ Individual, Over 18

____ Family, Persons residing in the same household

____ Youth, Persons age 18 or Under

• Races listed on Facebook & Web Site
• Race results listed on Facebook & Web Site
• Assistance in organizing races
• Assistance in paddling technique
• Assistance in finding partners
• Assistance in finding good equipment
• Assistance in knowing about racing

For family membership other than above, please list Names & Birth dates

Names ____________________________________________ Birth date ______________________

Names ____________________________________________ Birth date ______________________

Names ____________________________________________ Birth date ______________________

Names ____________________________________________ Birth date ______________________

Print form, complete application, enclose a check payable to Dallas Texas Canoe Club