Membership Application Form 2020-2021

Membership Application Form
Membership Year
Date of Memebership
Date

Month Day Year Hour Minutes AM/PM Option
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
E-mail *
Age *
Paddling Experience & Years *
(Include: dragon boating, rowing, canoe, kayaking, etc)

Membership Types
Choose Membership *

Adult Member Guest * College Student *** Youth Member **
Guest * - new to the sport of dragon boating and looking to try it out.

Student *** - a person that is enrolled in college under the age of 24 (Ages 18 to 24)

Youth ** - anyone of the ages 8 to 17

Team(s) you are affiliated with
Must choose a membership type first.

Please select one or multiple options. Please do not leave blank.
Breast Cancer Survivors

Phoenix Desert Dragons
Deciding
Must choose an option
Gender Team

AZDBA SunGi Arizona Monsoon
Mixed Seasonal Team

Arizona Dragon Riders Arizona Gila Dragons ASU Dragon Boat AZDBA MonGi Phoenix Fire Dragons
Youth Team

CrAZy Cuddlefish

Membership Fees
Choose Fees *

Breast Cancer Survivor $65 New Member $135 Prorated (a calculated value for new members only) Renewal Discount ^ $67.50 Renewal $135 Seasonal*$75 College Student**$55 Youth***$30
^ Renewal Discount Rate until July 31, 2020 to help paddlers $67.50

Seasonal * - for a paddler that is in for the winter.

Student ** - a person that is enrolled in college under the age of 24 (Ages 18 to 24)

Youth *** - anyone of the ages 8 to 17

Membership by PayPal
PayPal *

prev next ( X )
USD You must log into PayPal to complete the transaction

Waiver and Release of Liability
CLUB NAME: Arizona Dragon Boat Association

TERM: June 1st to May 31st of the membership year

Guest - Waiver and Release of Liability
CLUB NAME: Arizona Dragon Boat Association

TERM: June 1st to May 31st of the membership year

I understand that I can paddle with any team for 30 days as a guest after which I must become a regular member to be covered under the club liability coverage.

Minor - Waiver and Release of Liability
CLUB NAME: Arizona Dragon Boat Association

TERM: June 1st to May 31st of the membership year
Parent/Guardian Name *

First Name Last Name
Parent/Guardian Phone Number *
Parent/Guardian E-mail *
... *

I accept full responsibility of the minor under the age of 18 years old as parent or guardian.

Accept Responsibility and Liability
... *

I HAVE COMPLETED THIS APPLICATION AS REQUIRED AND ALL INFORMATION IS TRUTHFUL. I HAVE READ AND UNDERSTAND THE WAIVER AND LIABILTITY AGREEMENT AND ASSUMPTION OF THE RISK. BY CLICKING THE SUBMIT APPLICATION, I UNDERSTAND THAT I AM WAIVING CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE.
Math Challenge
If you are paying via Paypal you must sign in to complete the transaction. This will happen once you hit the submit button.
The Arizona Dragon Boat Association is a 501(c)(3) nonprofit organization whose primary mission and purpose is to promote the sport of dragon boating through community involvement and education for the state of Arizona. For more information, please visit us at www.azdba.org or e-mail info@azdba.org.

Now create your own JotForm - It's free! Create your own JotForm