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Please fill out the membership form completely
Incomplete information could delay your processing of membership application.

ADDRESS INFO
Membership Type *	VMB Membership ($30.00) Membership to the Virginia Mountain Bears for one full calendar year from the date of purchase. First time members receive a club tshirt. All members receive discounts on events and merchandise. VMB Renewal ($25.00) Membership renewals for VMB Club Members
Payment System *	PayPal Pay with a major credit card on Payplal using a secure credit card payment
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Choose a Password * Must be 4 or more characters
Confirm your password * Enter password again
Phone Number Please include your full phone number including area code or country code. example: 000-000-0000
Tshirt Size * Select your tshirt size for your club shirt
Birth Date Birthdate
Email Public * Can other VMBears Members see your email, default is N (No)
Phone Public * Can other members see your phone number, default is N - No
Address Public * Is your Address viewable to other members, default is N, (no)
Street
City
State
ZIP
Country