HRHS Membership Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Is this a renewal?
*
Yes
No
What is your address?
*
I am interested in being a volunteer, please contact me:
*
Yes
No
If purchasing a 'Family Membership', please list names for membership badges:
My Products
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Individual
Yearly Membership
$
20.00
Family
Yearly Membership* Family Memberships are good for up to 4 members of your family.
$
30.00
Lifetime Individual
Lifetime Membership
$
120.00
Lifetime Family
Lifetime Membership* (children/grandchildren under 18)Family Memberships are good for up to 4 members of your family.
$
200.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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