Docstoc

Little Sistahs in the Know_ Inc

Document Sample
Little Sistahs in the Know_ Inc Powered By Docstoc
					                                               MEMBER REGISTRATION

PROGRAM YEAR - 20              /20                      CHAPTER:                                     TODAY’S DATE:
ANNUAL MEMBERSHIP DUES: New Registrations – $44 Re-registrations – $34 (Sibling discounts DO NOT apply to returning members)
Sibling Discounts (NEW members only) – 1st sibling of new or returning girl(s) - $34; 2nd or subsequent sibling of new or returning girl(s) - $30
ENTER AN “X” BY REGISTRATION TYPE:
        New Registration (first time registering)       How did you hear about LSK?
        Re-registering           Previous Chapter:                           Previous Group:
Sister(s) also registering (YES or NO)?                 If YES, names:

Please email completed Member Registration form to membership@littlesistahsintheknow.org. Once received, you will be sent an invoice to pay Annual
Membership Dues securely online via Paypal (NOTE: a Paypal account is not required), which is the preferred method. If necessary, registration form
and check/money order (NO CASH) may be sent to Little Sistahs in the Know, Inc., MEMBERSHIP DEPT, P.O. Box 211771, Chula Vista, CA 91921.


GIRL’S NAME:         FIRST:                M.I.:                             LAST:                            NICKNAME:
                     AGE:                  BIRTHDAY:                         GRADE:                           SCHOOL:
ADDRESS:
CITY:                            STATE:                          ZIP:
HOME PHONE:                                EMAIL ADDRESS:

Girl is under the custodial care of (please place an “X” by one selection):
        both parents/guardians           mother/guardian           father/guardian             other – specify:


MOTHER/GUARDIAN’S NAME:
ADDRESS (if different from girl):
CITY:                            STATE:                                      ZIP:
HOME PHONE:                      WORK PHONE:                                 CELL PHONE:
EMAIL ADDRESS:

FATHER/GUARDIAN’S NAME:
ADDRESS (if different from girl’s):
CITY:                            STATE:                                      ZIP:
HOME PHONE:                      WORK PHONE:                                 CELL PHONE:
EMAIL ADDRESS:

EMERGENCY CONTACT:                                                           RELATIONSHIP TO CHILD:

HOME PHONE:                                                                  CELL PHONE:


New Registrations ONLY (each new member receives an LSK Tote Bag & T -shirt): Enter t-shirt Size: YOUTH (M, L, XL):                OR     ADULT (S, M, L):

Re-registrations (OPTIONAL): To order a new t-shirt or tote bag for a returning member, complete the “RETURNING MEMBER” section of the attached order form.

Additional T-shirt and tote bag orders: Order items for family and non-members by completing the “NON MEMBERS” section of the attached order form.

LSK OFFICIAL USE: Name of Person(s):                                                    Date Form Received:

Dues – AMT: $       ; DATE PAID:        ; ENTER an “X” for PAYMENT TYPE:                Paypal OR         Check #         OR           Money Order
Membership Roster Updated On (enter date) -         ;    Group Assignment:          ;    Group Coordinator Informed On (enter date):
Member Items Distributed (enter dates): Welcome Letter:           Bookmark:              Tote Bag:         T-shirt:



Last Updated 3/7/2010
Disclaimer
Little Sistahs in the Know, Inc., and all its subsidiaries, is indemnified from any actions resulting from unauthorized persons claiming
guardianship or otherwise exerting authority over a minor child without the express legal consent of the lawful parent or guardian.

Parental/Guardian Disclaimer

I,       , parent/guardian of minor child          of       (home address) agree that I will not for myself or for said minor child, hold
Little Sistahs in the Know, Inc. or the officers/directors of the corporation or the official volunteers of affiliate chapters of the
corporation liable for any injury or damage or loss suffered by said minor child while engaged in, or traveling to and from any
activities of or sponsored by Little Sistahs in the Know, Inc. or its affiliate chapters including, but not limited to, meetings, events, and
outings.

I understand that a requirement of said minor child’s participation in the activities of Little Sistahs in the Know, Inc. and its affiliate
chapters is that said minor child be accompanied and supervised by an adult at all meetings, events, and outings sponsored by the
organization and its affiliate chapters. In the event that neither I nor the said minor child’s other parent/guardian is able to attend a
given meeting, event, or outing with said minor child, I will make prior arrangements for said minor child to be under the care and
supervision of another member’s parent/guardian who is in attendance at the meeting, event, or outing. Specifically, the following are
names of adults with who said minor child may be under the care and supervision of at Little Sistahs in the Know, Inc. sponsored
meetings, events, or outings with:

Date:

Parent/Guardian Signature:


Photograph Image Waiver
I,       , parent/guardian of minor child         of      (home address) hereby give permission to Little Sistahs in the Know, Inc. of
P.O. Box 211771, Chula Vista, CA 91921 and/or parties designated by Little Sistahs in the Know, Inc., to use photographs of said
minor child in all forms of media, for any and all promotional purposes of Little Sistahs in the Know, Inc. including advertising,
publicity, display, audiovisual, exhibition, commercial, editorial, or website use. Only the said minor child’s photograph will be used
and no identification of the said minor child, any whatsoever, will be attached to the photograph.

I understand that the term “photograph” as used herein encompasses still photographs, audio recordings, and video footage.

I further consent to the reproduction and/or authorization by Little Sistahs in the Know, Inc. to reproduce and use such photographs
for use in all domestic and foreign markets.

I understand that the photographs will be the sole property of Little Sistahs in the Know, Inc. or its affiliate chapters.

I hereby release Little Sistahs in the Know, Inc. and any of its associates, affiliates, appointed advertising agencies, designated
directors, officers, agents, volunteers, employees, and customers from any claims.

Date:

Parent/Guardian Signature:


TERMS
By completing the above membership registration form and disclaimer page, and submitting said documents electronically to Little
Sistahs in the Know, Inc., you agree that the information entered is accurate, to the best of your knowledge, and you agree to the terms
of the disclaimers stated above. Additionally, please know that your child’s membership is not official until Annual Membership Dues
are submitted electronically via Paypal or received by the National Office by U.S. mail.

PRIVACY POLICY
Personal information entered on the membership registration form will be used by Little Sistahs in the Know, Inc. strictly for the
purpose of maintaining membership data and for communication purposes. The privacy of our members and their families is of utmost
importance to the organization. Your personal information will not be used for solicitation purposes and will not be distributed to third
parties by the organization.

Last Updated 3/7/2010
                                        Little Sistahs in the Know, Inc.
                                         T-shirt and Tote Bag Order Form

 RETURNING MEMBER SECTION                  Member Name:                             Chapter:

To order a new t-shirt(s) and/or tote bag(s) for a returning member, please complete the tables below, being sure to enter
the size of the shirt desired, as well as the color based on the member’s grade as follows:

1st – 2nd Grade (Little, Little Sistahs) -YELLOW
                                          YELLOW
                                          YELLOW
3 rd - 5th Grade (Little Sistahs) - OR ANGE
                                    ORANGE
                                    ORANGE
                                LME
6th - 8th Grade (Big Sistahs) -LIIIME
                                L ME
YOUTH T-shirt ($10 each)
   SIZE                     COLOR                  QUANTITY         COST (Quantity x $10)
M
L
XL
TOTAL

ADULT T-shirt ($15 each)
   SIZE                     COLOR                  QUANTITY         COST (Quantity x $15)
S
M
L
XL
TOTAL

LSK Tote Bags ($10 each)
                           QUANTITY         COST (Quantity x $10)
TOTAL




 NON MEMBERS SECTION                       Name:

To order additional t-shirt(s) and/or tote bags for non members (e.g. siblings, parents, friends, etc…), please enter the
sizes of the shirts desired and the number of tote bags requested. All t-shirts for non members are the color WHITE.
YOUTH T-shirt ($10 each)
   SIZE                  QUANTITY           COST (Quantity x $10)
M
L
XL
TOTAL

ADULT T-shirt ($15 each)
   SIZE                  QUANTITY           COST (Quantity x $15)
S
M
L
XL
TOTAL

SPECIAL SIZE ADULT T-shirt ($18 each)
    SIZE               QUANTITY             COST (Quantity x $18)
XXL
TOTAL

LSK Tote Bags ($10 each)
                           QUANTITY         COST (Quantity x $10)
TOTAL




Last Updated 3/7/2010
                                          Little Sistahs in the Know, Inc.
                                        T-shirt and Tote Bag Order Form (cont.)

GRAND TOTALS (add all quantities and costs from previous page):

TOTAL Number of t-shirts:
TOTAL Number of totes:

Total Cost:                                    $
_____________________________________________________________________________________

Name of Person Completing Order Form:

Email Address:

Contact Number:

Member Name:

Chapter Name:

Chapter Director:

__________________________________________________________________________________________________

Orders for t-shirts and tote bags may only be submitted ONLY during the August-October and January-March
Membership Registration periods. If you have a need to order a replacement t-shirt or tote bag for a MEMBER
that does not fall within one of the registration time periods, please send an email to
membership@littlesistahsintheknow.org to make a special request.

Submit T-shirt and Tote Bag Order Form via email to membership@littlesistahsintheknow.org. Once received,
you will be emailed an invoice and will be able to make a secure online payment via PAYPAL. All orders must
be PRE-PAID in advance. Paying online via PAYPAL is the preferred method and will allow for quicker
processing, however, if necessary, you may submit payment for your order by making a check or money order
payable to Little Sistahs in the Know, Inc., ATT: Membership Department, P.O. Box 211771, Chula Vista,
CA 91921. Be sure to include a copy of this order form with your payment.

All orders will be shipped to your local Chapter Director or to the alternate address provided by the Chapter
Director. Please allow 4 weeks from receipt of your payment to receive your order. If you have any questions
about your order, please email them to membership@littlesistahsintheknow.org or call the National Office at
(619) 591-8821.



LSK OFFICIAL USE: Date Order Received:             Total Cost:

DATE PAID:              ENTER an “X” for PAYMENT TYPE:       Paypal OR   Check #   OR   Money Order
DATE SHIPPED:




Last Updated 3/7/2010

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:18
posted:3/7/2010
language:English
pages:4