The Yankee Flyers Dog & Disc Club
Membership application
§ Circle one New or Renewal
Handler(s) information
1. First, last name:________________________________
2. Street address:________________________________
3. City/State/zip:_________________________________
4. Phone #/email: _(___)____-_______/_______________
Family/Juniors or Others in same household: Mark below if JR.
1. First, last name:___________________________[ ]age_____
2. First, last name:___________________________[ ]age_____
Disc Dogs Information
1. Dogs name:_____________________
Breed/age/approx. wt:______________/______/_______
Circle one that best describes you and your dogs ability:
Beginner Intermediate Advanced Expert
2. Dogs name:_____________________
Breed/age/approx. wt:______________/______/________
Circle one that best describes you and your dogs ability:
Beginner Intermediate Advanced Expert
Signature/date (of all applying for membership)
1. _____________________________date__________
2. _____________________________date__________
3. _____________________________date__________
*Signature of parent or guardian for juniors (17 yrs old and younger)*
T-Shirt Size(s) (indicate how many of each size): __M __ L __XL __XXL
§Renewed memberships have choice of: (please cirlce one) T-Shirt(s) or 6(12) Discs
Yearly membership $25 per person/ $35 for family(single membership receives 1 T-shirt, Family membership receives 2 T-shirts).
Please make checks payable to The Yankee Flyers Dog & Disc Club.
Send your checks to:
YFDDC c/o Carrie Neri
65 Music Vale Rd
Salem, CT 06420
For additional information: discdogger96@aol.com