Membership Form

VSSEAC MEMBERSHIP APPLICATION FORM


Membership Info: (please print legibly!)


NAME:    	  							   		 EMAIL:


ADDRESS:		 						 CITY:   	   	    	   	  	   		POSTAL CODE:

PHONE:	                        FAX:		 						 SINGLE PARENT: ____ yes  ____ no


AGE RANGE:   __ 18-29,   __ 30-39,   __ 40-49,   __ 50-59,   __60+



OCCUPATION: 



How did you hear about VSSEAC? ________________________________________  
 
Please assist us by being specific, thank you!

    
If a VSSEAC member, please name: ____________________  Coupon code: ______________



Enclosed please find a cheque _____ or money order for $______

made payable to Visit Vancouver


Activities/Interests:

5 ACTIVITIES I ENJOY: (please circle)

Bicycling · Skiing · White water rafting · Festivals · Dinners · Moonlight Cruises · Concerts · Parties · 
Swimming · Hiking · Golfing · Horseback riding · Travel · Hot air Ballooning · Comedy nights · Wine tasting ·
Cooking Classes · Workshops · Rock Climbing · Karaoke Nights · Boating · Discussion groups/Guest speakers · 
Sailing · Tennis · Kayaking · Dancing · Cards nights · Special Events · Theater · Volleyball · Canoeing ·
Kite flying · Air ballooning · Hiking · Dancing · Picnics · Movie nights · Breakfast socials ·
Other (please indicate)
________________, ______________, ________________, ________________, _________________

SOME ACTIVITIES I WOULD LIKE TO SEE SCHEDULED: (if not listed above!)

________________, ______________, ________________, ________________, _________________

I AM AVAILABLE TO PARTICIPATE IN ACTIVITIES MOSTLY ON (please check all that apply)

____ weekday evenings ___ weekends days  ___ weekends evenings

By signing below, I have read and agree:

At no time, on any occasion, will I hold anyone responsible for any damages to property and/or equipment 
sustained by myself while participating in an event or trip.  Nor will I hold anyone criminally 
responsible for any personal injury, illness or death as a result of signing up for an event, trip or activity. 
I understand that if I am under the influence of drugs and/or is causing a disruption to other people,
that I will be asked to cease participation and will do so. I will be solely responsible for my safety while 
participating in an event, outing or activity. I will not hold anyone responsible for any lost or stolen 
goods of any kind. Visit Beautiful Vancouver Online/Vancouver singles socials and events activities club (VSSEAC)
can at their sole and arbitrary discretion,  cancel an event or withdraw my participation or membership at any time. 
I understand and agree that refunds are never issued unless an event or activity has been cancelled. I understand and 
agree that my membership fee is not refundable. I can cancel my membership by email notification and transfer it to 
another person. Only one transfer per year is permitted by myself should I decide to cancel my membership and notification 
is required to Visit Beautiful Vancouver Online/Vancouver singles socials and events activities club (VSSEAC) prior to 
the transfer. By completing this membership application and using Visit Beautiful Vancouver Online/Vancouver singles 
socials and events activities club (VSSEAC) services I agree not to bring litigation against Visit Beautiful Vancouver 
Online/Vancouver singles socials and events activities club (VSSEAC), or its associates, without limitation. 


NAME: _________________________ SIGNATURE: ____________________________________ DATE: ________________

* Please make sure all information is completed. Thank you!

Visit Vancouver, c/o VSSEAC, 806-916 W. Broadway, Vancouver, BC V5Z 1K7

NAME:	EMAIL:
ADDRESS:	CITY: POSTAL CODE:
PHONE: FAX:	SINGLE PARENT: ____ yes ____ no
AGE RANGE: __ 18-29, __ 30-39, __ 40-49, __ 50-59, __60+
OCCUPATION:
How did you hear about VSSEAC? ________________________________________ Please assist us by being specific, thank you! If a VSSEAC member, please name: ____________________ Coupon code: ______________
Enclosed please find a cheque _____ or money order for $______ made payable to Visit Vancouver