Camp Creek Threshers Membership

FormP.O. Box 422

Waverly, NE 68462

 

Circle one: Single $20 Family $30 Cash or check Membership card given ___

 

Please fill out and mark what committee you would like to be on.

 

Name: __________________________________________________________

 

Spouse Name: _________________________________ Joining as member    Yes____ No ____

 

Names and ages of children under age 16: Name: __________________ Age: ______

 

Name: ________________ Age: ______          Name: ________________ Age: ______

 

Address: ________________________________________________________

 

City: ______________________________ State: ___________ Zip: __________

 

Phones:Home: _________________ Cell: _________________ Work: _______________

 

E-mail address: ____________________________________________________

                          (for use to receive monthly newsletter)

 

 

__ Advertising                         __ Food Stand                __ Raffle                        __ Announcers                 __ Gas Engines

__ Recycling                              __ Antique Tractors      __ Gas Station              __ Restrooms                    __ Baker Fan

__ Grain Hauling                      __ Rock Crushing          __ Baler/Bailing            __ Grist/Grinding Mills     __ Saw Mill

__ Bee Hut                                __ Grounds/Flowers     __ School                       __ Blacksmith                    __ Handicap Parking

__ Shellers                                __ Buttermaking            __ Harness/Saddles    __ Shocking/Hauling         __ Campers/Gate

__ Heavy Equipment              __ Signs                           __ Carts                          __ Horses                           __ Snyder Building

__ Children’s Playground       __ Ice Cream Stand       __ Steam Building        __ Church/Services           __ Information Booth

__ Steam Crane                       __ County Store             __ Kiddie Pull                __ Steam Engines              __ Craft Building

__ Main Gate                           __ Summer Kitchen       __ Depot                        __ Memorials                      __ Threshing/Bundles

__ Drug Store                          __ Parade                        __ Tickets                       __ Entertainment               __ Popcorn  

 __ Tractor Pulls                      __ Exhibitors Gate          __ Post Office               __ Trams                              __ Flea Market

__ Print Shop