Membership Application Form

Bedford County players Membership Application

To apply for membership please complete all questions.
I am Applying for
If applying for a Family Membership, we will contact you for the names of the other individuals in your home
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Cellular Number
Theater Interests and Abilities

ActingDirectingStage ManagerPublicityPhotographerPropsSoundLightsCostumesBackstageSet BuildingPaintingStage CrewBox OfficeConcessionsMaintenanceOutdoor WorkOther

My Subscriptions

Individual MembershipMembership for Individuals over 18

$10.00 for each year

Junior MembershipMembership for Individuals under 18

$5.00 for each year

Family membershpMembership for Families

$25.00 for each year

Billing Adress

Use the address above.I want to specify a different billing address.
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Signature*

MonthDayYear
Date
Signature*

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Bedford County players Membership Application