Membership Form

Name:
Spouse's Name:
Address:
Home Phone:
Email Address:
Children's Names and Dates of Birth:
Are you new to town?	Yes No
Check Activities you are interested in:	Babysitting Co-Op Book Discussion Group Family Bowling Wine Tasting Playgroups Lazy Gourmet Guys Night Out Wine & Women Girls Night Out Sports Club
I would be interested in helping with:	Children's Holiday Party Family Picnic Civic Opportunities Budget/Disbursement/Scholarship Committee Nominating Committee Directory Committee Children's Fair Fundraising Meals to members in need Open House Activities

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