Sandwich Mothers Club
2019-2020 Membership Form
Your Name
Your answer
Street Address, Town, State, Zip
Your answer
Mailing Address (if different)
Your answer
We are currently offering membership at $35! This allows your membership to run from now through Aug '20. Please pay via this link now: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=GAWQJ6JZ6AJQ6 *
Please confirm
Telephone Number
Your answer
Email Address
(By providing your email, you will receive the SMC constant contact updates and the SMC newsletter)
Your answer
Are you a new member?
If yes, how did you hear about SMC?
Your answer
In an effort to get to know our moms better, we will feature each of you on our Facebook group with some fun facts! Would you like to be included in MOM CRUSH MONDAYS (MCM)? *
(MCM)* Would you rather cook or clean?
Your answer
(MCM)* Where is your favorite place to visit?
Your answer
If you are pregnant, when are you due?
MM
/
DD
/
YYYY
Children's Names & Ages
Your answer
Volunteers
The SMC’s successful continuation is a result of the willingness of members to volunteer to plan activities and serve on committees. If you are interested in volunteering, please check below and a board member will be in touch with you!
Any special skills?
Your answer
Do you have Facebook? If so, please request to join our Facebook page at:
Waiver and Release of Liability: In consideration of the risk of injury while participating in All Activities and Meetings (the "Activity"), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigners, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Sandwich Mothers Club, located at Sandwich, Massachusetts 02563, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors, and assigners, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to the Activity. *
I hearby sign this liability disclaimer form on the
MM
/
DD
/
YYYY
I understand that all activities I participate in this event are done out of my own risk and I accept all responsibility. I agree not to bring any claim against the organizers of this activity or members involved in the event. I have read and accepted the terms of this liability disclaimer agreement. *
Participant(s) Names: (include yourself and family members)
Your answer
Photograph Waiver: I grant Sandwich Mother's Club the right to take photographs of me and my family in connection with any club initiated event. I authorize Sandwich Mother's Club, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Sandwich Mother's Club may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.
I hearby sign this photo waiver form on the
MM
/
DD
/
YYYY
Signature of acknowledgement of photo waiver. (By not including names below, you do not wish the Sandwich Mother's Club to use your picture in any form)
Participant(s) Names: (include yourself and family members)
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service