Membership

"*" indicates required fields

Coupon

Select Membership Type*

Individual

Family

Name*

First Last

Spouse/Partner's Name

First Last

Family Members

The family members identified can participate in all association contests and tournaments.

Children Under Age 17

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Your Email*

Boat Name

Committee Work of Interest

Board Member - Meetings third Monday of Month

Fish-N-Fun - May, one day event

Fund Raiser - assist with Fundraiser prep

Contests - May through Sept, tally results

Newsletter - Semi-Monthly production

Rearing Pond - April/May cleaning, feeding, etc

Pike Creek Cleanup - September, one day event

Favorite contact method

Text Message

Cell Phone

Home Phone

Email

Postal Mail

Yearly Recurring Membership

Price:

Total

Comments

This field is for validation purposes and should be left unchanged.

Δ

Footer

Kenosha Sportfishing and
Conservation Association

P.O. BOX 746
KENOSHA, WI 53144

Email address:

Leave this field empty if you're human: