To qualify as a new member
you must be: Please initial
Catholic
Single, never- married
Ages of 21-45 Annulled
Name:
Address 1:
Address 2:
City: State:Zip:
Home Ph.#:
Birthdate:
Email:
Home
Parish:
How were you referred to us?
Would you be interested in attending one or more of
the following committee meetings? You can check more than one box.
Social
Recreational
SpiritualCommunity
Unconditional
Waiver of Liability:
The undersigned, in
condition of being admitted as a member to St. Ladislas Singles
Group, hereby, absolutely, unconditionally and irrevocably waives any
and all liability or claim thereto that the undersigned may have against
St. Ladislas Church, St. Ladislas Singles Group, its Executive Board,
and its individual members, as a result of any and all activities,
functions, outings, and other social events of every nature, type, and
description whatsoever, and agrees to hold St. Ladislas Church, St.
Ladislas Singles Group, its Executive Board, and its individual members
harmless from and against any and all cost, damage, expense, or
liability resulting from any such claim. The views and actions of
any member or prospective member are not necessary those of the
group. I acknowledge that I have read and accept all terms and
conditions of this form and its membership. I acknowledge that
freely choose to be bound by these terms and conditions.
Signature:
Date:
Please complete, print and
return this form along with a check for $15.00 (hard copy of
newsletter by mail) or $10.00 (Electronic Newsletter by email) made payable to : "St. Ladislas
Singles Group" to:
St. Ladislas Singles Group
Attn: Membership
2345 Bassett Road
Westlake, OH 44145