Silver Buckle Membership Application

We are happy that you are interested in joining Silver Buckle! Please fill out the form completely and pay your membership fee with PayPal. Choose "family and friends" when you pay with Paypal to avoid additional fees. If you do not receive a confirmation email, your payment did not go through. Please do not go to PayPal until you are ready to complete the payment. Going backwards in PayPal or having an incomplete payment might result in receiving an inaccurate confirmation email.

You must complete your membership form by April 30th to be on the WSCA roster for this year. The online membership form will close on April 30th at midnight.

MEMBERSHIP INFORMATION

Type of Membership *

Individual Membership (18& over) - $35

Family Membership - $60

Do your family members have more than one last name? *

Yes

No

How would you like your family's last name (s) written on the roster? One last name or two last names as shown below: *

Your First Name *

Your Last Name *

Cell Phone Number (include dashes xxx-xxx-xxxx) *

Are you able to receive club communications over text? *

Yes

No

Email *

Are you able to receive club communications by email? *

Yes

No

Street Address (House number and Street) *

City *

State *

Zip Code *

Member Age Classification

Members Age Classification as of Janurary 1, 2023 per WSCA Rules:

PeeWee: 10 years and Under Senior: 18 to 34 years

Junior: 11 to 13 years Senior + : 35 to 49 years

Intermediate: 14 to 17 years Senior ++ : 50 years and over

Birthdate (Month-Day-Year) *

Your Age Division *

Year End Awards

Are you interested in competing for year end Awards? *

Yes

No

By choosing "Yes" above, you imply that you have read, understand, and agree to the new 2024 worker requirements attached below. There have been many changes to the work requirements this year. Have you read the worker requirements attached below? Please contact Kirstin or Crystal if you have any questions about the new requirements and look for a work requirement survey in your email. *

Yes

No

Second Family Member

First Name *

Last Name *

Birthdate (month-day-year) *

Age Division *

Cell Phone (include dashes xxx-xxx-xxxx)

Does this member want to receive club communications by text?

Yes

No

Email Address

Does this member want to receive club communications by email?

Yes

No

Is this family member interested in competing for year-end awards, and, if yes, does this family member understand the work requirements? *

Yes

No

Do you want to add an additional family member to your membership? *

Yes

No

Third Family Member

First Name *

Last Name *

Birthdate (month-day-year) *

Age Division *

Cell Phone (include dashes xxx-xxx-xxxx)

Does this member want to receive club communications by text?

Yes

No

Email Address

Does this member want to receive club communications by email?

Yes

No

Is this family member interested in competing for year-end awards and, if yes, does this family member understand the work requirements? *

Yes

No

Do you want to add an additional family member to your membership? *

Yes

No

Fourth Family Member

First Name *

Last Name *

Birthdate (month-day-year) *

Age Division *

Cell Phone (include dashes xxx-xxx-xxxx)

Does this member want to receive club communications by text?

Yes

No

Email Address

Does this member want to receive club communications by email?

Yes

No

Is this family member interested in competing for year-end awards and, if yes, does this family member understand the work requirements? *

Yes

No

Do you want to add an additional family member to your membership? *

Yes

No

Fifth Family Member

First Name *

Last Name *

Birthdate (Month-day-year) *

Age Division *

Cell Phone (include dashes xxx-xxx-xxxx)

Does this member want to receive club communications by text?

Yes

No

Email Address

Does this member want to receive club communications by email?

Yes

No

Is this family member interested in competing for year-end awards and, if yes, does this family member understand the work requirements? *

Yes

No

Payment

Checkout Fee *

5.0%

Current Total (Please press the calculate button to see your total):

$0.00