MEMBERSHIP – FAMILY

$150.00

Family Member Names

Please let your family member names, plate numbers, and races.

Family Member Names – 16 and Under

Please list the family member names, plate numbers and races for those16 and under.

Family Member Names – 17 and over

Please list the family member names, plate numbers and races for those 17 and over.

First Name *

Last Name *

Date of Birth

Month *

Day *

Year *

Address *

City *

State *

Zip Code *

Phone *

Rules *

I have read the 2024 UMIRA Rules.

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