TULSA ROUGH RIDERS
***APPLICATION***
Mail to: c/o TRR
1202 S. Saint Louis Ave, Tulsa, OK 74120
Website: www.tulsaroughriders.com
(Print out and bring to next club meeting/event)

Application Date:______________ (Dues will be owed this month each calendar year and are non-refundable.)
***You must be at least 21 years of age***

Please mark the appropriate section below as it applies to you:
I wish to be
______an Associate With Intent ( to become a FULL member)
-or-
______an Associate

It is understood that the Tulsa Rough Riders (TRR) is a gay/bisexual leather/levi/fetish association. Annual dues are $15.00. Additional fee(s) for "colors" ARE refundable should I wish to resign at a later date. I agree to abide with the by-laws of the TRR and to conform to the rules of any scheduled meeting or event. I do hereby waive all liability with respect to TRR; its officers, members and associates; the clubs/bars/related event facilities; the City/County of Tulsa; the state of Oklahoma; any other city/state where an event may be held; and all of their respective entities where any meeting/event is held for loss or injury caused to my person, property - and to any guest of mine his her person, property - for the duration of any meeting/event. My signature on the following page indicates I have read and agreed to this entire application.

IT IS UNDERSTOOD THAT IF THIS APPLICATION IS NOT APPROVED, THEN THE APPLICATION DUES SUBMITTED FORTHWITH OR HEREIN WILL BE REFUNDED IN FULL.

For promotional purposes my picture/image may be included on any webpage or printed matter. I have either submitted a face/torso picture of me herein (which can be returned later if a self-addressed stamped envelope is included/submitted) or I agree to have such picture(s) taken of me at a later time.

* If I DO NOT WISH ANY PICTURE/IMAGE OF ME TO BE USED, I HAVE INITIALLED HERE:____

· I heard about TRR from the following source(s):

· Knowing that this does NOT preclude me from becoming an associate or a full member of TRR, but helps TRR in planning meeting/events, I am a member or an associate of the following:
__________T.U.L.S.A                        ________Tulsa Dungeon Society
__________Driller Bears                     ________SSRA
__________Other: (specify)___________________________________

· My interests and/or reasons for joining TRR are as follows - (please be as complete as possible with your own comments here):
_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_____________________________                      _________________________________________
Applicant Signature                                                                         Printed Name and D.O.B.

_____________________________                      _________________________________________
Witness Signature                                                                         Printed Name

____________________________________________________________________________________________________
Address of Record (where any receipt(s) or notifications may be sent in the future)

(_____) _______ - ____________ Telephone number where you can be reached - or indicate this is a "message" number only

_______________________________________________________________________
Email Address


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FOR THE OFFICERS OF TRR:

Amount of dues received: ___________ Date received: _________________

Associate armband "colors" given/delivered on _________________________