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CASA Membership Application Form:

It is the obligation of every CASA member to volunteer to work 4 hours per year on range maintenance at work parties called by the range masters
or the president. Members who cannot attend work parties may opt out by including an additional $20.00 with this application. By becoming a member
of CASA the principal member agrees to those terms. Members who have attained age 60 during the calendar year and who have 10 years of continuous,
active membership in CASA shall be exempt from work party participation and the buyout fee.

Please enclose $20.00 for single membership or $25.00 for family membership.
Mail check (made out to CASA) to:
Rick Rogers
1262 Lasterbrook Street
Placentia, CA. 92870-3906


IF EMAIL ADDRESS IS PROVIDED AN EMAIL COPY OF THIS APPLICATION WILL BE SENT BOTH TO YOU AND
RICK ROGERS MEMBERSHIP DUES WILL STILL BE REQUIRED TO BE MAILED TO ADDRESS ABOVE. THANK YOU.

You can also print out a copy of this application and mail it via US Mail to the address above.   [ PRINT FORM  ]

Membership Range Work Options:
Option A) I agree to the 4 hour per year range maintenance work requirement.
Option B) I agree to opt out of range maintenance by including $20.00 in addition to the membership fee with this application.
Option C) I am 60 years of age with 10 consecutive years of membership in CASA and exempt from the work obligation.

Range Work Options:	Select Maintenance Work Requirement (** THIS FIELD IS REQUIRED **)   I agree to the 4 hour per year range maintenance work requirement. I agree to opt out of range maintenance by including $20.00 in addition to the membership fee with this application. I am 60 years of age with 10 consecutive years of membership in CASA and exempt from the work obligation.
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Email Address:
Home Phone Number:
Cell Phone Number:
Cell Phone Number:
Emergency Contact:
Emergency Phone Number:

   

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