Document Sample
					                         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:
    _ New
    _ Renewal
                                             MEMBERSHIP/RENEWAL                                                                                 ___/___/___

                                                   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.