LIBERTY CRUISERS CAR CLUB

MEMBERSHIP FORM

NAME: _____________________________________________________________

ADDRESS: ___________________________________________________________

PHONE NUMBER: _____________________________________________________

EMAIL: _____________________________________________________________

T-SHIRT SIZE: ______SMALL  ______MED ______LG _____XL  _____XXL  _____XXXL

MEETINGS ARE HELD ONCE A MONTH ON THE SECOND SUNDAY.

DURING CLUB CRUISING MONTHS, MEETINGS ARE HELD BEFORE OUR CRUISE INS.

DUES ARE $15 PER SINGLE OR COUPLE & INCLUDES 1 T-SHIRT PER PERSON (OR 2 T-SHIRTS PER COUPLE AT INITIAL PAYMENT OF DUES).  

YEARLY DUES ARE $10 (FOR 1 SINGLE OR COUPLE & INCLUDES 1 CRUISE IN CALENDAR).

COMPLETE THIS FORM ALONG WITH $15  DUE PAYMENT TO:

LIBERTY CRUISERS CAR CLUB

7830 WOODBINE AVE

FORT WAYNE, IN  46825

FOR ADDITIONAL INFO, PLEASE CONTACT:

Dene Roby:  260-466-5060 or Mike McHenry:  260-609-2928  or 

Email:  www.libertycruisers@yahoo.com