Season2024-2025
Application Statusnew
Membership TypeIndividual ($30/yr) ($30.00)
Primary Account Holders NameMichael Bohen
Address327 Sunset Ave
Rensselaer, New York 12144
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Phone(518) 763-8815
EmailEmail hidden; Javascript is required.
Vaccination StatusVaccinated
Acknowledgement
  • I acknowledge and represent that I have read and understand it and that I agree to it voluntarily and for full and adequate consideration, fully intending to be bound by the same.
Payment Amount$30.00
Payment DateMarch 5, 2025
Payment MethodPayPal
Payment StatusPaid
Transaction ID5L0420741K967774T
Approval StatusUnapproved