BAYOU BOWMEN ARCHERY CLUB

MEMBERSHIP INFORMATION
NEW IBERIA, LA
INDOOR: 4900 S LEWIS ST
OUTDOOR: 5020 W OLD SPANISH TRAIL
PRES. RICKY ST. UPERY 337-364-0561
VP NEECIE FALGOUT 337-380-7999

NAME:______________________________________________________________________

ADDRESS:____________________________________________________________________

CITY, ST ZIP__________________________________________________________________

PHONE NUMBER_____________________ EMAIL____________________________________________

DATE OF BIRTH________________________

ADDITIONAL FAMILY MEMBERS:

NAME________________________________________ DATE OF BIRTH_____________________

NAME________________________________________ DATE OF BIRTH_____________________

NAME________________________________________ DATE OF BIRTH_____________________

FEES check one:

⃞ single indoor ⃞ single outdoor ⃞ single indoor and outdoor ANNUAL MEMBERSHIP INFORMATION
⃞ family indoor ⃞ family outdoor ⃞ family indoor and outdoor Outdoor membership: Single member $100 /
Family $125
BBAC ASA affiliation fees (optional) Indoor membership: Single member $75 /
⃞ Individual $50/yr. ⃞ Family $70/yr. Family $100

Combined membership: Single member $150 /

Family $200
TOTAL FEES: ______ All dues are due Jan 1st and prorated monthly
at time of application.

I ____________________________________ am at least 18 years old and have read and agree to abide by all rules set forth by Bayou Bowmen
Archery Club and its affiliated state and national organizations. I also agree that should I or any of my guests fail to abide by such rules my
membership may be revoked without a refund of my fees.

Signature: _____________________________________________________