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Membership Form
Please fill out form completely.
Make check payable to Tri Gulfcoast and mail to:
TRI Gulfcoast
PO Box 544
Gulf Breeze, FL 32562-0544 |
First Name:
Last Name:
Email
address:_______________________________________________
| Check One: |
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New Member |
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Renewal |
| Check One: |
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Annual Individual $15.00 |
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Annual Family $20.00 |
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family Membership, list additional family members and birth
dates: |
Name |
Birth Date |
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I agree to abide by all decisions
made by the club and its board. I understand and assume all risks
associated while participating in all club sponsored events. I will not
participate unless I am medically fit and properly trained. having read
this waiver and knowing these facts and in consideration of the
acceptance of my application for membership, I, for myself and anyone
entitled to act on my behalf, waive and release TRI Gulf Coast and all
sponsors, their representatives and successors from all claims or
liabilities of any kind arising out of my participation in these club
activities even though that liability may arise out of negligence or
carelessness on the part of persons named in this waiver.
Signature:___________________________
Date:__________
Parent/Guardian if under
18:__________________________ Date:__________ |