SMITHFIELD ATHLETIC BOOSTER CLUB
SMITHFIELD HIGH SCHOOL SMITHFIELD ATHLETIC BOOSTER CLUB (SABC) MEMBERSHIP FORM
SCHOOL YEAR 2016/2017 FOR OFFICIAL SABC USE ONLY:
DATE: ____________ PLEASE CHECK ONE:
Member Renewal
New Member
MEMBERSHIP TYPE (check all that apply):
Received by:__________________ Date received: ________________ Received by membership:________ Info Provided to AD:____Dt_____
SABC MEMBERSHIP FEE / $5 per person, per school year 1st Member Name:______________________________ 2nd Member Name:__________________________________
10 PUNCHCARD PASS / $50 (10 athletic events pass for home games, includes 1 SABC membership fee) Member Name:________________________________________ 20 PUNCHCARD PASS / $95 (20 athletic events pass for home games, includes 1 SABC membership fee) Member Name:________________________________________ FAMILY PASS / $180 (5 family member entrance into all home games, includes 2 SABC membership fees) *Families with more than 5 family members may ADD ON additional family members for only $20 each 1st SABC Member Name:___________________________ 2nd SABC Member Name:___________________________ Three other family members to be listed on Family Pass: 3._____________________________________________ 5._____________________________________________
4. ___________________________________________
Yes, ADD ON a family member to my Family Pass for $20/per person? Member Name:________________________ TOTAL AMOUNT DUE
$_______________
Additional information for above Member and their Student(s): EMAIL ADDRESS_________________________________ 2nd EMAIL ADDRESS_____________________________ HOME STREET ADDRESS __________________________________________________________________________ CITY _________________________________________________________________ ZIP ________________________ PRIMARY PHONE # ____________________________ SECONDARY PHONE # ______________________________ LIST ALL SMITHFIELD MIDDLE/HIGH SCHOOL STUDENTS IN FAMILY: NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ Thank you for your support. If you would like to offer your time and talents to Smithfield Athletic Booster Club, we would love to have your assistance! Please consider helping with the following committees (check all areas you can contribute to):
Board member Concessions (indicate type of sports event) _____________________________________ Fundraising Spirit wear/apparel Website Sponsorship General volunteer Membership Publicity Awards Night Funds Distribution Other ? (please list all below) Please list any other skills, interests or talents:_____________________________________________________________ Are you or your company interested in Sponsorship Opportunities?
Yes
No
Please mail form to Smithfield Athletic Booster Club, P.O. Box 95, Smithfield, VA 23431-0095 PAYMENT TYPE: Cash - Amount Received $__________
Check - Amount $________ Check #______
(Please make check payable to Smithfield Athletic Booster Club.)
Revised August 2016
SCHOOL YEAR 2016/2017 FOR OFFICIAL SABC USE ONLY:
DATE: ____________ PLEASE CHECK ONE:
Member Renewal
New Member
MEMBERSHIP TYPE (check all that apply):
Received by:__________________ Date received: ________________ Received by membership:________ Info Provided to AD:____Dt_____
SABC MEMBERSHIP FEE / $5 per person, per school year 1st Member Name:______________________________ 2nd Member Name:__________________________________
10 PUNCHCARD PASS / $50 (10 athletic events pass for home games, includes 1 SABC membership fee) Member Name:________________________________________ 20 PUNCHCARD PASS / $95 (20 athletic events pass for home games, includes 1 SABC membership fee) Member Name:________________________________________ FAMILY PASS / $180 (5 family member entrance into all home games, includes 2 SABC membership fees) *Families with more than 5 family members may ADD ON additional family members for only $20 each 1st SABC Member Name:___________________________ 2nd SABC Member Name:___________________________ Three other family members to be listed on Family Pass: 3._____________________________________________ 5._____________________________________________
4. ___________________________________________
Yes, ADD ON a family member to my Family Pass for $20/per person? Member Name:________________________ TOTAL AMOUNT DUE
$_______________
Additional information for above Member and their Student(s): EMAIL ADDRESS_________________________________ 2nd EMAIL ADDRESS_____________________________ HOME STREET ADDRESS __________________________________________________________________________ CITY _________________________________________________________________ ZIP ________________________ PRIMARY PHONE # ____________________________ SECONDARY PHONE # ______________________________ LIST ALL SMITHFIELD MIDDLE/HIGH SCHOOL STUDENTS IN FAMILY: NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ NAME:________________________________GRADE/AGE: _____________ SPORT(S):__________________________________ Thank you for your support. If you would like to offer your time and talents to Smithfield Athletic Booster Club, we would love to have your assistance! Please consider helping with the following committees (check all areas you can contribute to):
Board member Concessions (indicate type of sports event) _____________________________________ Fundraising Spirit wear/apparel Website Sponsorship General volunteer Membership Publicity Awards Night Funds Distribution Other ? (please list all below) Please list any other skills, interests or talents:_____________________________________________________________ Are you or your company interested in Sponsorship Opportunities?
Yes
No
Please mail form to Smithfield Athletic Booster Club, P.O. Box 95, Smithfield, VA 23431-0095 PAYMENT TYPE: Cash - Amount Received $__________
Check - Amount $________ Check #______
(Please make check payable to Smithfield Athletic Booster Club.)
Revised August 2016
