COACHELLA VALLEY COUPLES
A Social Organization for Committed Gay and Lesbian Couples
Contact Sam and Tedd, Member Services Couple
Our Mission Statement:
Coachella Valley Couples (CVC) is an organization in which the members are committed gay
and lesbian couples of the Coachella Valley in Southern California and beyond. This
Organization serves to provide a forum for those member couples to strengthen their own
relationships while providing a social and supportive structure for their fellow member couples.
CVC holds no religious or political affiliations and makes every attempt to respect the privacy
of its members.
Please check one: Today’s Date:
Last updated: September, 2008
PLEASE PRINT CLEARLY
Your name: _________________________________________ Date of Birth: mo___/day___
Partner’s name: _________________________________________ Date of Birth: mo___/day___
Mailing Address: ________________________________________________________________
City: _________________________________________ State: _________ Zip: ________-_____
Phone Numbers: Home __________________________ Others __________________________
Email: _______________________________________ Anniversary: mo___/day___/year_____
List your hobbies, interests, specialties:
Signature #1 ___________________________ Signature #2 ___________________________
Membership dues are $45.00 per couple for the first year; $40.00 each year thereafter.
New memberships/renewals will run for one full year from the month the couple joins or renews.
Two photo badges are included in your 1st year membership dues. Badge pictures are taken at CVC events.
Please make check payable to Coachella Valley Couples sending it along with this application to:
CVC, P.O. Box 4104, Palm Springs, CA 92263-4104
If you require assistance with paying the annual dues, please include an explanation with your application.
CVC in no manner subscribes to nor supports any discrimination except that individuals under the age of 18 shall not be eligible for general
membership. By joining CVC, I release and discharge CVC and the officers from all claims in any manner arising out of property damage and
personal injuries sustained by me as a result of participating in any club activity. I waive the right to every lay claim for injuries I might suffer before,
during or after any club event. Our photographs may appear in the CVC newsletter and/or website as participants at CVC events.