5._______________________________   6.___________________________________
YOUTH MEMBERSHIP
1.____________________________________   11._____________________________________
2.____________________________________   12._____________________________________
3.____________________________________   13._____________________________________
4.____________________________________   14._____________________________________
5.____________________________________   15._____________________________________
6.____________________________________   16._____________________________________
7.____________________________________   17._____________________________________
8.____________________________________   18._____________________________________
9.____________________________________   19._____________________________________
10.___________________________________   20._____________________________________
Use additional sheet(s) if necessary.
______ Total number Adults
______ Total number Youth
$___________ Total money recieved
received by ____________________________________________