Membership Application

Regular Membership Rates:
First-time: $80.00 per person
Renewals: $70.00 per person

Memberships are on an annual basis and are valid from the month of your enrollment.
Second membership at same address may join for one-half price ($40 for new; $35 for renewal).
Payment is due in full upon enrollment.
One-time annual payment breaks down to about $6.65 per month for first-time members; $5.83 per month for renewals.
We reserve the right to refuse membership to anyone.

STEP ONE- Complete this form. Items marked with a red * are required.

New or Renewal?

One or Two People?
(at same address)

Profile

*First Name:

*Last Name:

*E-mail:

Birthday:

Second Person at Same Address

First Name:

Last Name:

E-mail:

Birthday:

Address & Phone Numbers

*Street Address:

Apartment / Suite: #

*City:

*State:

Zip: *(5 digits)
-

*Home Phone:
() -

Work Phone:
() -

Fax:
() -

Questions

Please tell us how you heard about us:

Please list in order of preference your favorite three activities:

Activity One:

Activity Two:

Activity Three:

What other social, cultural or sporting events/trips would you like the club to organize?

*Are you willing to volunteer?

Are you able to provide your home for:
Meeting Place
Social Event

Emergency Contact

*Name:

*Relationship:

*Phone:
() -

Completion

Comments:
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*I have read and agree to the waiver (click to read).

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