TNVLC Membership Application
Personal Information
Last Name *
First Name *
Parent or Supervising Adult if under 18
(Applying as a Junior Member)
Email *
Street Address *
City *
State *
Zip Code *
Cell Phone Number
Home Phone Number
Birth Date *
LEGO Interest Survey
TNVLC Chapter *
Enter which Chapter of the Tennessee Valley LEGO Club you would like to join.
Please describe your areas of interest:
Other comments or questions:
Photo Release
This is not required, but is encouraged to facilitate documentation and promotion of club activities and events.
I give permission to Tennessee Valley LEGO Club (TNVLC) to use my photograph or photographic image in official Club business, including: Club Web Sites, Club newsletters and publications, etc. I hereby waive any right that I may have to inspect or approve the finished product and the advertising copy and/or other matter that may be used in connection therewith or the use to which it may be applied. I further release, discharge and agree to save harmless TNVLC and all persons acting under TNVLC's permission or authority from any liability that may occur or be produced in the taking or use of said photograph or photographic image.
If under the age of 19 please indicate status as Minor as defined by the state of Alabama. A separate photo release form is required.
Clear selection
Confirmation
I have read the bylaws of the Tennessee Valley LEGO Club (TNVLC) and by selecting "Yes" indicate I confirm their acceptance and espousal and seek membership in TNVLC. *
Submit
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