2023 USMRA Club Renewal Form (Renewals ONLY)
Club Name
*
Please Select
Independent - No Club Affiliation
Big Apple Mondioring
Bite-Club Mondio
Bite Co. Ringsports
Blackwood Bite Club
Evergreen Mondio Club
Evolution Working Dog Club
Fair Play Mondio
Fearless Ring Sport
Fire Pines Ring Club
First in Flight Ringsport
Genesis Mondioring
Good Company Working Dog Club
Heartland Working Dog Club
Intégrité Working Dog Club
Lone Star Mondioring Club
Marvel K9
Mile High Mondioring
Momentum Mondioring Club
Montana Mondioring Club
Motley Crew Mondio Club
Oceanside Mondioring Club
RedDirt Ringers
Rocky Mountain Guerrière
Santa Clarita Mondioring
SoCal Mondio
Spirit of Competition
St. Louis Working Dog Club
Synergy Ringsport Club
Texas Area Ring Team (TART)
Texas K9
West Penn Mondioring Club
Wild West Mondioring
Other- list*
Club Name if New Club
Date of Club's most recent trial. Club must host trial every 2 years.
-
Month
-
Day
Year
Date Picker Icon
Location of Club
*
City
State / Province
Zip Code
Club Contact Person
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
President of Club if not same as contact person
*
First Name
Last Name
Preferred form of Contact
*
Phone
E-mail
Facebook
Club Info for USMRA website - Example: Contact Person & his/her info, location, FB page or Website, etc.
*
USMRA web site can use the checked responses for USMRA Clubs web page :
*
Contact person
E-mail
Mailing Address
Phone
Club Insurance Info - If private individual/club policy, list Company, Policy number and Contact info. You MUST attach or send policy copy to the USMRA Secretary. If your club has no private insurance write "USMRA". USMRA does not provide individual club insurance.
*
Club By-laws on file? New clubs must submit a copy of the Club By-Laws.
*
Yes
No
Names & addresses of Club members who are also current members of USMRA. At least 3 names required. Members in multiple clubs must choose PRIMARY club for accounting purposes.
*
By submitting this document, this club and it's members and agents agree to abide by USMRA by-laws, USMRA Code of Conduct and policies and procedures. We also agree to notify the USMRA Secretary in writing of any by-laws, membership or event changes, as well as event incidents and procedure deviations. USMRA is committed to an anti-discrimination policy in all of its programs. Membership entitles all members in good standing to attend all USMRA sanctioned events.
*
Agree
Signature:
*
Date
*
-
Month
-
Day
Year
Date
Please attach your Club By-laws here if not on file
USMRA Club Payment using PayPal
*
prev
next
( X )
USMRA Club Dues / Renewal
$
100.00
Proceed to Checkout
Office Use Only
Payment
Bylaws
Trial Requirement
3 Required Members
Should be Empty: