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Biggest Little Swing Dance Club Membership Application and release of Liability
Complete this form below and click Submit. Then mail your check to: B.L.S.D..C., P.O.B. 10541, Reno, NV 89510 (Indicate applicant's name on the check.)
For any information that you do not want published in the club roster, please indicate with an asterisk (*) next to your entry, in each box you want excluded. Only one newsletter will be mailed for a joint membership. The first person’s last name is the alphabetical listing for the roster.
The Membership and the Waiver & Release of Liability will also apply to the co-applicant if this is a joint application. "R" indicates Required fields.
Check what applies (R): New Renewal Individual ($30) Joint($50)
Birthday #1: Month/Day
Occupation #1
E-Mail #1: R
Birthday #2: Month/Day
Occupation #2
E-Mail #2: R
Street:R City, State, Zip:R
Phone (HM) R (WK)
Sponsor’s Name: Willing to assist with club activities?
How did you hear of us?
WAIVER AND RELEASE OF LIABILITY I have been notified that the Biggest Little Swing Dance Club (BLSDC) accepts no liability for injury occurring from my participation in any club activity including dances, lessons or workshops, or social functions. I have been advised to carry my own medical and accident insurance. All information collected is for club use only and will not be sold or distributed. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY ACCEPTING IT, AND ACCEPT IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, BY ENTERING A "Y" FOR YES.
Enter a capital "Y" for yes:
(To print a copy of this Waiver and Release of Liability, click on your browser's PRINT function, above.)
