Membership Profile - All information remains confidential.


*Designates a REQUIRED FIELD.
ALL REQUIRED FIELDS MUST BE FILLED OUT IN ORDER FOR THE FORM TO BE PROCESSED!


Personal Information
*First Name:. *Last Name:..
*Address:..... *City:............ *State: .........
*Zip Code:.... *Telephone:... *Email: ........
Work Phone: Cell Phone:....
Second Person Living at Same Address
First Name:... Last Name:...
Work Phone: Cell Phone:... Email:..
For Our Information

Please list in order of preference your favorite three activities:
#1 ...#2 ...#3

Please list your top three travel destinations:
#1 ...#2 ...#3

What other social, cultural or sporting events/trips would you like the club to organize?...

Would you be interested in attending activities that include children? ... Yes ...No
Pets?... Yes... No

Are you willing to volunteer?... Yes... No

Are you able to provide your home for: Meeting Place and/or Social Event? ... Yes ... No

Please tell us how you heard about us:... Publication ... Friend ... Other

If other, please specify....


Emergency Information
Emergency Contact Name: Emergency Phone Number: Relationship:

Payment Information

Annual Membership:

First time: $80.00 per person
Renewals: $70.00 per person
Memberships are on an annual basis and valid from the month of your enrollment.
Second membership at the same address may join for one-half price.
Payment is due in full upon enrollment.

Number of Memberships ...


Contact Information

Welcome To Our Family, Please Contact:

Gianina Ferrari, Evelyn Hernandez-Velez, or Teresa Perez

Email : shevo@sheventuresout.com ....... Telephone : (305)762-6128

***I have read and agreed to all the terms of the Waiver Agreement... Yes ... No

Home Page


Solution Graphics