Fort Des Moines Rangers, Inc 2026 Membership/Renewal Form

Fort Des Moines Rangers, Inc 2026 Membership/Renewal Form

$25.00 for Single Membership or Renewal; $35.00 for family. (Family includes self, spouse/significant other, children under 18). You may register up to 2 additional family members using this form. Contact FDMR if you need to add more than two family members.
RenewalNew Member
Single MemberFamily
Name*

First NameLast Name
Alias
SASS # (if applicable)
Date of Birth*
RO IRO II
1st Family Member Name*

First NameLast Name
1st Family Member Alias
1st Family Member SASS # (if applicable)
1st Family Member Date of Birth*
RO IRO II
NoYes
2nd Family Member Name*

First NameLast Name
2nd Family Member Alias
2nd Family Member SASS # (if applicable)
2nd Family Member Date of Birth*
RO IRO II
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact (Name/Phone)

My Products

Single Membership

$25.00

Family Membership

Family includes self, spouse/significant other, children under 18. (This form is built for up to 3 total members. Contact FDMR if you need to register more than 3.)

$35.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: