Keystone Lionhead Rabbit Club

Membership Application/ Renewal

Name __________________________________________________

Address_________________________________________________

_______________________________________________________

Phone___________________

Email__________________________________________________

Website________________________________________________

Please check if you want your website/ email included in club directory that will be posted on the internet. ________

ARBA# ___________

Please Circle One:

New Membership

Individual $10.00

Youth $5.00

Family $15.00

Renewal

Individual $5.00

Youth $3.00

Family $8.00

Please make checks payable to:

Keystone Lionhead Rabbit Club

Mail to: Secretary/ Treasurer

Tony Kelly

824 Mountaindale Rd

Fallentimber, PA 16639