National Show Roller Association
New Membership Information
Adult Member________ Junior Member________Age________
Name: ________________________
Address:_______________________________________________
Phone #:___________________ Cell:________________________
E-Mail:________________________________
Band Order: Bands are sold in 50 to100 bands to a string.
50 bands = $15.00
100 bands = $30.00
Membership Dues:
$20.00 Adults
$10.00 Juniors
Please make your check out to NSRA send to:
Sam Wesley
3709 Pepperell Pkwy
Opelika, Al. 36801
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