SEATTLE
SLEEPLESS SINGLES Membership Form
Complete the following
form, print, and send along with your annual memberrship fee
of $42 to Seattle Sleepless Singles, P.O. Box 3313, Kirkland,
WA 98083-3313
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First:
Last:
Address:
city:state: zip:
Date
of Birth: Sex:Email:
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Phone: Work
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In
consideration of accepting my membership in the Seattles Sleepless
organization, I, the undersigned, intending to be legally bound
hereby, for myself, my heirs and administrators, waive and release
any and all claims for damages I may have against the Seattle
Sleepless organization, its officers or representatives, successors
and assigns for any and all injuries suffered by me as a result
of my membership in Seattle Sleepless Singles and attendance at
or participation in, and of its events or activities. Enclosed is $42 for ANNUAL MEMBERSHIP made payable to "Seattle
Sleepless Singles".
