2026 Membership Renewal

Membership Renewal

Membership ($100.00)

Member's Name

Nickname (Optional)

Date of Birth

Gender

Male
Female

Address

Member Home Phone Number (Optional)

Member Cell Number (Use parent # if no member cell #)

Member Email (Use parent email if no member email)

Member's Disability

Ethnicity

Parent or Guardian Information (If Applicable)

Name

Address

Home Phone Number

Cell Phone Number

Work Phone Number

Additional Family Members (Parent/Sibling) Registering

Name

Relationship

Name

Relationship

Name

Relationship

Member Signature *(Finger Signature Required)

Your signature indicates the Member Information above is correct.
The information listed will be added to the North Texas SNAP, Inc. database.

I, the undersigned, agree to the terms above.

Parent Signature *(Finger Signature Required)

Your signature indicates the Member Information above is correct.
The information listed will be added to the North Texas SNAP, Inc. database.

I, the undersigned, agree to the terms above.

EMERGENCY TREATMENT RELEASE

Signature of Participant *(Finger Signature Required)

I authorize the person in charge to seek and obtain on my behalf emergency medical treatment. I also authorize transportation to the nearest medical facility in the event it should become necessary.

I, the undersigned, agree to the terms above.

Signature of Parent/Guardian *(Finger Signature Required)

I authorize the person in charge to seek and obtain on my behalf emergency medical treatment. I also authorize transportation to the nearest medical facility in the event it should become necessary.

I, the undersigned, agree to the terms above.

PUBLICITY RELEASE

Photo Terms

**North Texas SNAP asks all guests to refrain from tagging or identifying individuals in pictures posted on social media. We prefer all pictures taken at any NTX SNAP event be posted on our private Facebook Member Page or Parent /Caregiver Page. **

I have read and agree to the terms above.

Signature of Participant *(Finger Signature Required)

I hereby give my permission to use photos, videos or other digital media (“photographs”) taken at SNAP events and activities for the purpose of promoting and representing SNAP.

I understand that my photographs may be used in informational and promotional materials including newsletters, flyers, posters, brochures, fundraising information, the SNAP website, social networking sites and other print and digital communications.

I, the undersigned, agree to the terms above.

Signature of Parent/Guardian *(Finger Signature Required)

I, the undersigned, agree to the terms above.

DONATIONS

Donations to North Texas SNAP help fulfill the organization’s mission to “Create and support a variety of programs that assist individuals 17 and older living with intellectual disabilities in achieving and sustaining full lives.” At this time, if you would like to make an additional donation along with the yearly membership, please add the amount below. Thank you for supporting North Texas SNAP members and programs.

Processing Fee

$3.20

Total

$103.20

SNAP Membership Renewal

Renewal by credit card/check for 2026 membership

Parent or Guardian Information (If Applicable)

Additional Family Members (Parent/Sibling) Registering

EMERGENCY TREATMENT RELEASE

PUBLICITY RELEASE

DONATIONS

Billing Information