NEW MEMBERSHIP | Greensburg Rec

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Memberships

First Name

Last Name

Email

Phone

Sex

Male

Female

Age

Date of Birth

Title

Mr

Mrs

Ms

Miss

Street Address

City

Postal / Zip code

Region/State/Province

Membership Type

Single Monthly - $10.69

Single Year - $103.30

Family Monthly - $12.74

Family Year - $123.88

Senior Monthly (60+) - $5.54

Senior Year (60+) - $51.85

Members to be included: (only applicable to family membership)

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Call Us: 620-723-1110 / gburgrec@gmail.com / 600 S Main Greensburg, KS 67054

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