Application

 

Print this membership application page or click here and then print :

The Spa City Bop and Swing Dance Club is a Non-Profit organization directed toward entertainment and fellowship of it’s members, dedicated to the preservation of Bop, Swing, and Jitterbug dancing.

DUES ARE $20.00 PER PERSON PER YEAR.

As a member you will receive our club newsletter and calendar, which can be obtained from our website spacitydanceclub.com , or e-mailed to you, or can be picked up at the front desk at our next dance, member fee admission to regular and specialty dances, and dance lessons will be offered by the club prior to regularly schedule Friday night dances.

Please fill out completely.

NAME _________________________________

BIRTH DATE M/Day ____ / ____

NAME_________________________________

BIRTH DATE M/Day ____ / ____

ADDRESS_______________________________________________

CITY_____________________ State__________ Zip___________

HOME PHONE (____) __________________

WORK PHONE (____) __________________

CELL PHONE (____) __________________

EMAIL__________________________________________BY

BY SUBMITTING THIS APPLICATION, I RELEASE THE SPA CITY BOP AND SWING DANCE CLUB FROM ANY AND ALL LIABILITIES. I ALSO UNDERSTAND THAT MY MEMBERSHIP CAN BE REVOKED FOR ACTIONS INAPPROPRIATE OR DETRIMENTAL TO THE CLUB OR ANY MEMBER.

SIGNATURE____________________________ DATE ____________

SIGNATURE____________________________DATE_____________

Please Make Checks Payable to: SPA CITY BOP AND SWING DANCE CLUB

Mail to: P.O. BOX 4309, HOT SPRINGS, AR 71914 - 4309

This application can be given to any Board Member for your convenience or you may mail the application to the above address. A membership card will be forwarded to you. For more information you may contact the Membership Director at 501-318-1373 or email to bterauchi@hotmail.com