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Make check payable to Brandon Rescue. Send $60 with your name & address to:
Brandon Area Rescue Squad, Inc.
1338 Franklin St, Brandon, VT 05733
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I agree to the
I hereby apply for subscription to Brandon Area Rescue Squad, Inc. for myself and the members of my household listed. I understand that the $60 per household per year subscription fee provides local emergency medical and emergency ambulance services to me and the members of my household as medically necessary in the Brandon Area Rescue Squad, Inc. service area.
I understand that this subscription expires on May 31, 2027 regardless of when I initiate my subscription. I also understand that this subscription permits Brandon Area Rescue Squad, Inc. to collect directly from any third-party agency whatever benefits may be available at no charge to me or my family, and that this membership is non-refundable and is non-transferable.
I further understand that my payment alone is agreement to the above membership rules and limitations.
I understand that this subscription expires on May 31, 2027 regardless of when I initiate my subscription. I also understand that this subscription permits Brandon Area Rescue Squad, Inc. to collect directly from any third-party agency whatever benefits may be available at no charge to me or my family, and that this membership is non-refundable and is non-transferable.
I further understand that my payment alone is agreement to the above membership rules and limitations.
Total Due
$60
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