ZaCSA Membership Form

ZaCSA Membership Form
Name*

First NameLast Name
E-mail*
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Were you referred by a ZaCSA member? Please tell us their name.
So we can high-five them!

ZaCSA Photo Release Consent
I hereby grant permission to Zama Community Spouses’ Association (ZaCSA) to share and use my photos on Facebook, Instagram and the ZaCSA website as publication, promotion, illustration, and advertising of their community group. I also grant permission to Zama Community Spouses’ Association to use photos that I or my family members are in for publication, promotion, illustration, and advertising purposes. I hereby release Zama Community Spouses’ Association from all claims and liability relating to said images.

DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on
this application.
Member Name

First NameLast Name
I acknowledge that I am*

Over the age of 18The legal guardian of the following minor's name:
Name of Minor

First NameLast Name

ZaCSA Responsible Drinking Policy

Per Zama Community Spouses’ Association (ZaCSA) policy, the following is for your information and safety:
Agree to all before continuing:*

1) I have been informed that Japan has a zero tolerance law when it comes to drinking and operating a motorized vehicle or riding a bicycle. This zero tolerance law applies to Camp Zama and Sagamihara Housing Area.2) I acknowledge that if I drink alcohol at ZaCSA events, it is my responsibility to coordinate appropriate transportation, i.e. designated driver, walk, train, taxi, in order to abide by Japan’s zero tolerance law on drinking and operating a motorized vehicle or riding a bicycle.3) I accept full risk and responsibility if I choose to ignore Japan’s zero tolerance law and I do not hold ZaCSA responsible for my actions.
Thank you for your understanding and compliance.

If you have any questions concerning this policy, please contact the ZaCSA president directly at zacsa.president@gmail.com.

Waiver and Liability Release

Terms and Release of Liability
Terms: The Zama Community Spouses’ Association, it’s owners, associates, agents, and companies shall not be held responsible for and shall accept no liability in respect of any claims, losses, damages, costs, or expenses arising from personal injury, financial setback, sickness, disease, accident, or death insured during any ZaCSA events, however caused, without limitations. Loss of or damage to baggage or other property caused by weather, equipment failure, or any other causes will not be the responsibility of ZaCSA or its representatives. ZaCSA strongly prohibits consuming alcohol or taking illegal drugs while operating a motor vehicle during any ZaCSA planned events. We reserve the right to decline or refuse any person participating in our events should they not conform to these guidelines or terms.

Waiver Agreement: I understand and accept the terms, conditions, and information contained herein. I hereby accept all risks of personal injury and property damage arising from my participation in all ZaCSA planned events, to include while using or in ZaCSA members’ personal vehicles, public transportation, government vehicles, ZaCSA members’ households, government property, and off-post public property. I agree that I, my dependents, heirs, and executors indemnify ZaCSA and its volunteers, owners, board directors, members, and representatives against any and all claims or costs. Further, by signing this form, I certify that I am a SOFA Card holder and have health insurance. I understand that I will wear a seat belt while motor vehicles are in motion and follow all Japanese and US Forces motor vehicle driver and passenger laws.
I have fully read and agree to abide with the Terms and Release of Liability as stated above:*

I agree to the Terms and Release of Liability as stated above.I DO NOT agree to the Terms and Release of Liability as stated above.
DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.
Name*

First NameLast Name
Date Signed*

MonthDayYear
Date

You're almost there! One last step - please pay your yearly membership dues. If you are unable to complete an online payment, please contact membership.zacsa@gmail.com to arrange alternative forms of payment.

My Products*

Early Bird ZaCSA Membership

$20.00

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ZaCSA Membership Form

ZaCSA Photo Release Consent

ZaCSA Responsible Drinking Policy

Waiver and Liability Release

Payment Methods