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.
Renewal/New Member
Are you registering a Single Member or a Family?
Name

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

First NameLast Name
1st Family Member Alias
1st Family Member SASS # (if applicable)
1st Family Member Date of Birth
1st Family Member RO I / RO II
Do you want to add a 2nd Family Member
2nd Family Member Name

First NameLast Name
2nd Family Member Alias
2nd Family Member SASS # (if applicable)
2nd Family Member Date of Birth
2nd Family Member RO I / RO 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

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: