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Viking Backer Membership Form 2021-2022
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* Indicates required question
Email
*
Your email
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
Student 1 Name and Grade (include last, if different than parent)
*
Your answer
Student 2 Name and Grade (include last, if different than parent)
Your answer
Student 3 Name and Grade (include last, if different than parent)
Your answer
Student 4 Name and Grade (include last, if different than parent)
Your answer
Membership Level
*
Black and Gold Membership $120 (includes magnet, $12 concession card, and blanket)
Viking Membership $75 (includes magnet and $12 concession card)
Hebron Membership $40 (includes magnet)
Proud Grandparent $25
I would like to receive communication regarding opportunities to volunteer with the Viking Backers at activities and events throughout the year.
*
Yes
No
I would like to learn more about opportunities to promote my business through the Viking Backers.
*
Yes
No
Business name and Preferred business contact
Your answer
A copy of your responses will be emailed to the address you provided.
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