ACTION Membership Form

ACTION, Inc. Membership Application
Member Information:
Student Full Name*

First NameLast Name
Sex
Parent/ Guardian name (if student is a minor):

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthday*

MonthDayYear
Date
Phone Number*
E-mail*
example@example.com
How did you hear about us?
Other
Membership at ACTION, Inc. allows you to particpate in all events hosted by ACTION. Sponsorship of your membership is $200 for one entire year. This donation covers your costs for attending events, meals during events, and all other services provided by ACTION. There is NO COST to our members for ANY activites or membership, but we will attempt to obtain a sponsor for your membership.
Do you have a sponsor for your ACTION, Inc. membership?*

NoYes (Sponsors can pay via PayPal, Venmo, Facebook Donation, Cash, or Check)
T-Shirt Size (Adult Unisex):*
Tell us about yourself! (hobbies, sports, interests, etc.)*
Describe what a perfect day would look like to you:*
Allergies:
**if applicable
Parental Consent Forms
REQUIRED

I, First Name Last Name give permission for my child, First Name Last Name to participate in events and classes held by ACTION, Inc. I understand that ACTION, Inc. and its volunteers are not held liable or responsible for any incidents and/or any damaged/stolen property while my child is participating in ACTION, Inc. events or being transported by an ACTION, Inc. employee or volunteer.
Parent/Guardian Signature*

Clear
OPTIONAL

I, First Name Last Name give permission for my child, First Name Last Name to be photographed while at ACTION, Inc. events. These photos may be shared on the ACTION, Inc. social media pages. I also understand that no royalties, fees, or other forms of compensation will be payable to me by such use.
Parent/Guardian Signature

Clear
OPTIONAL

I, First Name Last Name give permission for my child's photo and general information (such as hobbies and interests) to be used to obtain sponsorship for their ACTION, Inc. membership.
Parent/Guardian Signature

Clear
Should be Empty:

ACTION, Inc. Membership Application

Member Information:

Parental Consent Forms