Cruisin’ Couples Membership Application

Date of Application ___/___/___

Name __________________________

Spouse’ Name ___________________

Address ________________________

City _______________State ________

Zip Code _________

Phone ( ) ____ ______

E-Mail Address __________________

Car Make __________ Year _____

Model _________ Color ______

Class:

Stock __ Modified__ Simi Mod. __ St. Rod __

Signature of Owner _________________________

Sponsor’s Name ____________________________

We go together stay together, park together & never leave anyone behind!

His DOB __/__/__

His Shirt size

S ___

M ___

L ___

XL ___

XXL ___

Anniversary date ___/____/__

Her DOB __/__/__

Her Size Shirt

S ___

M ___

L ___

XL ___

XXL ___

Annual Dues $25

Club Theme Song CD & Medallion included

monogrammed shirts $27.50 ea.

Optional

Monogrammed Jacket $52.50

Walkie Talkies $45

This club is a bit different than most clubs,

We have a limited membership of 25 and it’s for folks who love driving these old cars. So if would rather snooze than cruise this is not for you.

For more information Call Kent Thall Cruisin’ Couples President 352-255-2232

Make Check Payable to Cruisin’ Couples

1340 Spring Lake Rd.

Fruitland Park Fl. 34731