San Diego Smooth Dancers

A Nonprofit Corporation to Encourage and Support Ballroom Dancing

A chapter of National Smooth Dancers, Inc. since 1949

Application for Membership

San Diego Smooth Dancers, Inc. is a non-profit club whose members are amateur dancers. We are a chapter of National Smooth Dancers, an organization with chapters in several California cities. Benefits include reduced admission to monthly dance socials and opportunities to participate in local and statewide ballroom dance competitions and showcase events. Application fee: $10. Membership Fee: $40 per year (Due in Jan., prorated quarterly).

Total of $______submitted with this Application for Membership.

Date of Application: ______Month and Day of Birth: ______

Name: ______Male/Female Married: _____ Single:_____

Mailing Address: ______

City: ______Zip: ______Phone: ______

E-mail address______Secondary Phone______

What first name do you prefer? ______Are you a legal resident of the USA? Yes______No ______

Please state your reason(s) for wanting to become a member of San Diego Smooth Dancers. ______

Have you ever been a member of National Smooth Dancers? Yes___ No __Number of Smooth Dancers Socials Attended:______. Do you regularly attend SD Dance Classes? Yes ____ No ____. If yes, for how long? ______If not, do you plan to attend club-sponsored dance classes? Yes ______No _____. Members are expected to attend meetings and support the various functions of the club. All members are expectedto serve this organization, on a committee, work at socials, as an officer, or do various other tasks.

Please initial that you agree ______. Other Activity (explain)______.

Please list any special ability or talent that you might wish to share with the club: (For example, can you sing, act, or write? Are you artistic, handy with tools, decorating, computers, etc.?) ______.

Other interests: ______

Name of Club member sponsor ______Signature______

Name of second club member sponsor______Signature______

Applicant Signature:______Date Application submitted:______

DATE APPLICATION APPROVED: ______

National Smooth Dancers Liability Waiver

I/we understand & agree that the National Smooth Dancers Inc. (including all chapters) will not be held responsible for loss or theft of articles, nor be held liable for injuries sustained by persons dancing and or competing at any chapter or National Smooth Dancers events. I/we hereby irrevocably give and grant to the National Smooth Dancers Inc. (including all chapters) the right toproduce, use, refer to or reproduce any still photographs taken and video/audio recordings made at any and all chapter or National Smooth Dancer events. (Note: We will do our best to remove or eliminate from publication any photograph or video that features a member and is objectionable to that member.)

Requirements for Membership: 1. Must be legal resident of USA. 2. At least 21 years old. 3. Good moral character. 4. Attend two social club parties. 5. Attend one business meeting. 6. Have two sponsors that are club members. 7. Pay the application & membership fee.

Make check payable to: San Diego Smooth Dancers

Mail to: Cynthia Perry, Membership Chairman/VP, 1319 Burris Drive,El Cajon, CA 92019