I have read the PRIVACY POLICY, TERMS of USE, and DISCLAIMER *

AGREE

DISAGREE

Captain Cell Phone

Cell Phone Only

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Stoker Cell Phone

Cell Phone Only

(###)

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Phone Land Line (leave blank if no landline)

Land line only, no cell phones.

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Parent/Guardian Consent of Above Participants *

By checking agree, the parent or guardian hereby consents to the applicant's participation and waives and releases all rights and claims for damage as is more fully set forth above in our disclaimer. Parent or guardian must choose agree or disagree if applicants are under 18. If you are adding no children choose "not applicable."

AGREE

DISAGREE

NOT APPLICABLE

PAYMENT *

Payment may be made using credit card, Zelle, or check. Regardless of payment method, all must click the submit button below. Upon submitting this form, you will be directed to our purchase page, where you will be able to pay by credit card. If you are paying by Zelle or check, you may disregard the purchase page, then IF USING ZELLE, submit payment to: catstreasurerkc@gmail.com IF PAYING BY CHECK, send the check to: Chicago Area Tandem Society 1533 Naperville Lane Batavia, IL 60510 Select your payment method:

CREDIT CARD

ZELLE

CHECK

New Member? *

YES

NO - WE WERE IN LAST YEAR

NO - RETURNING FROM A YEAR PRIOR TO LAST YEAR