Fort Des Moines Rangers, Inc 2026 Membership/Renewal Form
$25.00 for Single Membership or Renewal; $35.00 for family. (Family includes self, spouse/significant other, children under 18). You may register up to 2 additional family members using this form. Contact FDMR if you need to add more than two family members.
Renewal/New Member
*
Renewal
New Member
Are you registering a Single Member or a Family?
Single Member
Family
Name
*
First Name
Last Name
Alias
SASS # (if applicable)
Date of Birth
*
RO I / RO II
RO I
RO II
1st Family Member Name
*
First Name
Last Name
1st Family Member Alias
1st Family Member SASS # (if applicable)
1st Family Member Date of Birth
*
1st Family Member RO I / RO II
RO I
RO II
Do you want to add a 2nd Family Member
*
No
Yes
2nd Family Member Name
*
First Name
Last Name
2nd Family Member Alias
2nd Family Member SASS # (if applicable)
2nd Family Member Date of Birth
*
2nd Family Member RO I / RO II
RO I
RO II
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Emergency Contact (Name/Phone)
My Products
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Single Membership
$
25.00
Family Membership
Family includes self, spouse/significant other, children under 18. (This form is built for up to 3 total members. Contact FDMR if you need to register more than 3.)
$
35.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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