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LA JOLLA NEWCOMERS CLUB
MEMBERSHIP APPLICATION

Click here to return to "Join Newcomers."


Name (please print):


Email:


Spouse/Parnter (if any):


Residence Address (no PO box please)


City & State:


Mailing address (if different from above):


City, State & Zip:


Phone:


Former home:


How did you hear of LJNC?


Application date:


INSURANCE WAIVER - PLEASE SIGN

At the recommendation of our insurance company, LJNC requires all members (including spouses/partners listed above) to sign the following waiver:

When participating in an event or activity held by or organized for members of La Jolla Newcomers Club, I acknowledge and agree that I do so at my own risk. I further waive, to the fullest extent permitted by law, all responsibility and liability of the Club, its officers and directors, other participants, and persons conducting the event or activity on behalf of the Club.

Signature: _______________________________

Date: ___________________________________

Signature: ______________________________

Date: ___________________________________