Membership Renewal Application

Blue Ridge Bernese Mountain Dog Club Membership Renewal Application

BRBMDC Membership Fees are due & payable by January 1 of each year and no later than March 31 of each year. Any membership with unpaid dues after March 31 is deemed lapsed. Membership may be reinstated upon submission of a Reinstatement Request Form, and subsequent approval by the Board.

The following defines each membership type:

Regular (Individual and Household) Membership: Member enjoys all club privileges, including the right to vote and hold office. Individual is a single person where a household/ family is 2 people.
- Members automatically convert to Regular memberships upon renewal for the next calendar year.
Associate (Individual and Household) Memberships: Associate Members are entitled to all Club privileges except voting and holding office. Associate Members shall be informed of all club meetings and activities; shall receive the newsletter; may serve on committees; and may participate in all club activities, but may not vote, hold office, sponsor, nominate or second. An Associate Member may transfer to Regular Membership at the time of yearly membership renewal and dues payment
- All new applications are approved as Associate Individual or Associate Household memberships
- Members who are not active and are not able to attend regular club meetings are encouraged to retain associate memberships to facilitate the Club’s ability to meet quorum requirements for voting at meetings. Associate Members are not counted in fulfilling quorum requirements

Please complete the entire form so we may update our club records.

* Indicates required field

Please Select your membership level *

Notes:

Regular Individual - One adult member in household
Regular Household - Two Regular members in the same household
Associate Individual- A limited membership option for anyone interested in the club, but unable to fully participate
Associate Household - Two Associate Members in same household
Junior - Open to persons 10-17 years of age
Only Regular Members vote/hold office
Payments to BRBMDC for dues or support of its programs are not deductible for tax purposes.

Member 1 *

First

Last

Home Phone *

Mobile Phone Member 1 *

Email Member 1 *

Are you a Bernese Mountain Dog Club of America (BMDCA) Member? - Member 1 *

Yes No

Member 2 *

First

Last

Mobile Phone Member 2 *

Email Member 2 *

Are you a BMDCA member? - Member 2 *

Yes No

Please update the fields below with any new information. If nothing has changed, there is no need to fill it out.

Address *

Line 1

Line 2

City

State

Zip Code

Country

Please enter information for any additional Family Members: *

Dog Information (Optional)

How many Bernese do you currently have? *

Kennel Name - Dog 1 *

Registered Name - Dog 1 *

Call Name - Dog 1 *

Breeder - Dog 1 *

Berner-Garde ID - Dog 1 *

Kennel Name - Dog 2 *

Registered Name - Dog 2 *

Call Name - Dog 2 *

Breeder - Dog 2 *

Berner-Garde ID - Dog 2 *

Kennel Name - Dog 3 *

Registered Name - Dog 3 *

Call Name - Dog 3 *

Breeder - Dog 3 *

Berner-Garde ID - Dog 3 *

Kennel Name - Dog 4 *

Registered Name - Dog 4 *

Call Name - Dog 4 *

Breeder - Dog 4 *

Berner-Garde ID - Dog 4 *

Please enter information for any additional dogs in comment box below. *

I, the undersigned, (by clicking the SUBMIT button below) hereby apply for membership renewal in the Blue Ridge Bernese Mountain Dog Club and hereby agree to abide by the Constitution and Bylaws and Code of Conduct of the Club, the Bernese Mountain Dog Club of America and the American Kennel Club now and hereafter made.

Upon Clicking the submit button, you will be presented with membership dues payment options.

Submit

(Renewal Form 10.2017)