Sacramento's Capital Crossroads Gay Rodeo Association

APPLICATION FOR MEMBERSHIP

Capital Crossorads is an organization of men and women eighteen (18) years of age or older sharing an interest in promoting, advancing, and developing the sport of rodeo and the "Western Lifestyle" in the GLBT and non-GLBT communities.

Membership dues are for one year. Family memberships are available to any two persons residing at the same address.

Membership Dues
Individual: $30.00 Family: $50.00

Primary Member Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

*Please provide the COUNTY/Region you live in on the same line as you enter the state you live in.
Phone Number *
### - ### - ####
Email *
Primary Member Birthdate *
MM / DD / YYYY
Members must be at least 18 years of age. Some Capital Crossroads events are held in locations with
age restrictions that will exclude members under the age of 21. Membership records are confidential
NAME You Wish To Appear On Your Badge *
CITY You Wish To Appear On Your Badge
Please Select Membership Below *

Individual $30.00

Renewal Individual $30.00

Family $50.00

Renewal Family $50.00

All new members receive a custom Capital Crossroads Name Badge and a Membership
Card. Please fill out "Family Member Information" if selecting a Family Membership.

***Please Note: You will be taken to our PayPal site after clicking the "SUBMIT" button. That is where you will process your payment information.
Family Member Information
Prefix First Last Suffix
Email
Family Member Birthdate
MM / DD / YYYY
Members must be at least 18 years of age. Some Capital Crossroads events are held in locations with
age restrictions that will exclude members under the age of 21. Membership records are confidential
NAME You Wish To Appear On Your Badge
CITY You Wish To Appear On Your Badge

Please Fill Out Form...