Membership
Member Registration
& Agreement
This is for Supporters and Members Only
*Required Fields
*Name____________________________________________________________________________
*Mailing Location__________________________________________________________________________
*City _______________________*St/Prov ________________*Postal Code[____________]
Bus. Tel (____)___________________* Home Tel (____)____________________
Fax (____ )______________________
Cell Tel (____)_______________________
E-mail ____________________________________
Ship to Mailing (if different)
Location____________________________________________________________________________
City _______________________St/Prov ____________________Zip/Postal[________________]
I, hereinafter denoted "Member", the under-signed, register being a Supporter-Member.
Member has carefully read and agreed with all the provisions of Membership under the Terms of Service/Terms Of Use ( http://www.rangeguide.net/terms.htm ) which constitute the Membership Policy.
Member understands that Member has the right to terminate this Agreement at any time, with or without reason. Member understands that the aforesaid termination must be in writing, signed manually and mailed Registered Mail. Member understands and agrees that Burk-Elder: Hale, Third, or his assigns, may terminate this Agreement at any time, with or without reason, and Member agrees to never circumvent Burk-Elder: Hale, Third by contacting his sources directly or indirectly by third parties in respect and recognition of his humanitarian labor.
Member’s Autograph____________________________________________________Date____/____/_______A.D.
Check the following:
____*Member has enclosed my $15.00 Membership registration
donation. Payable by: Silver, US Postal Money Order, Cashiers’ Check, Bank of America, or PayPal, without recourse.
All payments must be imprinted with maker’s autograph. Payments payable
Burk-Elder: Hale, Third.
Send completed Application (Fax 775-383-3378) to the following mailing
location exactly as written below:
Burk-Elder: Hale, Third
Seven-Zero-Two (702) Woodgate Road
Ringgold, Georgia [30736]
Or Fax an autographed copy to: 775-383-3378 and/or
send payment by mail or PayPal