Membership Application to FDRBA: 
Name: _____________________________________
Address: ____________________________________
City: _________________________ St: _____ Zip: _________
Phone: ______________________
E-Mail: ______________________
Youth $3.00 Adult $5.00 Family $10.00
Make Check payable to: Tina Garrison
Mail applications to: Tina Garrison
616 Alta Vista Street
Lake Wales, FL 33853
rascall127@msn.com #863-679-3337
