VERMIN Sign-up Form

Name
Street address
 
City
State/Province
Zip
Date
  Optional Fields
Email address (if any)
Nickname (if any)
Phone (optional)
List phone in VERMIN directory? Yes No
Bike info (yr, model, color...)
Print, then mail completed form, with check* or money order* for $15 (US dollars) to:

Myla Schorsch (Red Rider)
PO BOX 1864
Snohomish,WA 98291

OR

2) You can signup in person at one of our monthly meetings (second Saturday of each month) at:

Gators Sports Bar & Grill
21609 84th Ave S, Kent, WA
(253) 437-0362

*Make check out to: VOA - Vermin Chapter


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