BRC Membership Application

Personal Information

First Name:
Last Name:
Status:
Address:
City:
State:
Zip Code:
Birthday:
Cell Phone:
Email:
Primary member text blast opt-in Spouse text blast opt-in

By opting in to receive text blasts, I understand that I and/or my spouse can opt out at any time by contacting the Membership Chair. Standard messaging and data rates may apply. The Blue Ridge Club is not responsible for any charges incurred from your mobile carrier.

Membership Details

Physical Signature required from Primary Sponsor.

All sponsors must have at least one-year active membership.

Primary Sponsor: Secondary Sponsor #1: Secondary Sponsor #2: Add me to the campground waitlist

Spouse Information

Spouse Name:
Spouse Phone:
Spouse Email:
Spouse Birthday:
Anniversary:

6561 (assigned - can't change)

Notes:

Blue Ridge Club Membership Application

Personal Information

Membership Details

Spouse Information

PIN

$162.12