JoinRenewForm

Madison West Coast Swing Club

Online Membership Application/Renewal

New Member Application OR Current Member Renewal

First Name: Last Name:

Email:

Primary Phone: XXX XXX XXXX (e.g., 608 222 2222)

I am interested in helping with event check-in, set-up, and/or tear-down.

Please include my name and e-mail address in the club directory

Required Waiver

I hereby certify that I have been notifed that the Madison West Coast Swing Club, and its board members and instructors accept no responsibility for injury occurring out of or from my participation in or travel to any club meeting, class, dance or function. The Madison West Coast Swing Club has advised me to carry my own medical and accident insurance.

Initials: Date: mm/dd/yyyy (e.g., 02/21/2016)

By entering your initials and date you are affirming knowledge and acceptance of the waiver.

Click the Continue button to submit your application and proceed to online payment of your annual dues.

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