Membership Registration
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Email *
Name *
Phone Number ###-###-#### *
Date of Birth *
MM
/
DD
/
YYYY
Address *
Emergency Contact: Name, Relationship, Phone number
Membership *
Waiver
Please read.
Read & Initial 1
Initial to indicate you have read the above text. *
Read & Initial 2
Initial to indicate you have read the above text. *
Read & Initial 3
Initial to indicate you have read the above text. *
Read & Initial 4
Initial to indicate you have read the above text. *
Read & Initial 5
Initial to indicate you have read the above text. *
*
I further reaffirm my agreement, on behalf of myself or my minor child, with the terms of this liability waiver by electronically signing this document: (MUST follow format: "/s/ name") *
Sexual Misconduct
Read & Initial 1
Initial to indicate you have read the above text. *
Read & Initial 2
Initial to indicate you have read the above text. *
Read & Initial 3
Initial to indicate you have read the above text. *
Read & Initial 4
Initial to indicate you have read the above text. *
Check the following to indicate you have read it: *
Required
I further reaffirm my agreement with the terms of this misconduct form by electronically signing this document: (MUST follow format: "/s/ name") *
A copy of your responses will be emailed to the address you provided.
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