Membership Form
| ______ I am a current member of Pearl River Singles Circuit | |
| ______ I wish to join Pearl River Singles Circuit ($20.00 Annual Membership) ($15 from the membership and $10 from each Entry Fee are held for the Classic and Expenses.) TOTAL ENCLOSED $_______________ | |
| Name _____________________________________________________________
Address _____________________________________________________________ City/State/Zip ________________________________________________________ Day-Time Telephone __________________________ SS#_____________________________ Email Address: _______________________________________________________ |
Complete and Mail Entry
Form with check/money order to:
Randall Childs
307 Dan Stewart RD, Picayune, MS 39466
(601) 273-2117