Membership

LAKE MERCER DRAGON BOAT
ASSOCIATION, USA, INC.
MEMBERSHIP APPLICATION

I WOULD LIKE TO JOIN THE MIXED TEAM

I WOULD LIKE TO JOIN THE JUNIOR TEAM 14+

I HAVE A HISTORY OF CANCER AND WOULD LIKE TO JOIN THE
CANCER TEAM

NAME:________________________________________________

ADDRESS:____________________________________________

TELEPHONE#:__________________________E-MAIL_________

EMERGENCY CONTACT:_________________________________

RELATIONSHIP________________________REACH #:________

ABILITY TO SWIM? YES______        NO______

RIGHT HANDED ________        LEFT HANDED________

   P. O. Box 205
   Princeton, NJ 08542
   732-329-0888 Voice
   732-274-0570 Fax