Address City/State
For Office Use Only Date Paid _______
Date Entered ________
Tier I Code _________
Name ____________________________________ Birthday _____________________ Address __________________________________ City/State _____________ ZIP _______ Phone (home) ___________ (Cell) ___________ Email ____________________________ Emergency Contact Person _______________________________ (Phone) ______________ Member of Tates Creek CC ____ Guest of Tates Creek CC ____ Tier I - individual access ($25 per year) ______
Tier II - group access only ($10 per year) ______
I am interested in receiving regular emails regarding the following LIFE Ministries activities: □ Pickleball □ Basketball □ Zumba □ Martial Arts
If you are a guest, would you be interested in receiving information about the various ministries of TCCC? ____ If yes, which areas?_________________________________________________________________________ I, the undersigned, accept full responsibility for any accident or injury I may incur while occupying and utilizing all equipment and facilities associated with LIFE Ministries and Tates Creek Christian Church. I further accept all equipment for use is as is and agree to pay for any equipment I damage or break not brought about by usual wear and tear. I agree to abide by the rules and policies of LIFE Ministries. Signature
Date
For Office Use Only Date Paid _______
Date Entered ________
Tier I Code _________
Name ____________________________________ Birthday _____________________ Address __________________________________ City/State _____________ ZIP _______ Phone (home) ___________ (Cell) ___________ Email ____________________________ Emergency Contact Person _______________________________ (Phone) ______________ Member of Tates Creek CC ____ Guest of Tates Creek CC ____
Tier I - individual access ($25 per year) ______
Tier II - group access only ($10 per year) ______
I am interested in receiving regular emails regarding the following LIFE Ministries activities: □ Pickleball □ Basketball □ Zumba □ Martial Arts
If you are a guest, would you be interested in receiving information about the various ministries of TCCC? ____ If yes, which areas?_________________________________________________________________________ I, the undersigned, accept full responsibility for any accident or injury I may incur while occupying and utilizing all equipment and facilities associated with LIFE Ministries and Tates Creek Christian Church. I further accept all equipment for use is as is and agree to pay for any equipment I damage or break not brought about by usual wear and tear. I agree to abide by the rules and policies of LIFE Ministries. Signature
Date
Date Entered ________
Tier I Code _________
Name ____________________________________ Birthday _____________________ Address __________________________________ City/State _____________ ZIP _______ Phone (home) ___________ (Cell) ___________ Email ____________________________ Emergency Contact Person _______________________________ (Phone) ______________ Member of Tates Creek CC ____ Guest of Tates Creek CC ____ Tier I - individual access ($25 per year) ______
Tier II - group access only ($10 per year) ______
I am interested in receiving regular emails regarding the following LIFE Ministries activities: □ Pickleball □ Basketball □ Zumba □ Martial Arts
If you are a guest, would you be interested in receiving information about the various ministries of TCCC? ____ If yes, which areas?_________________________________________________________________________ I, the undersigned, accept full responsibility for any accident or injury I may incur while occupying and utilizing all equipment and facilities associated with LIFE Ministries and Tates Creek Christian Church. I further accept all equipment for use is as is and agree to pay for any equipment I damage or break not brought about by usual wear and tear. I agree to abide by the rules and policies of LIFE Ministries. Signature
Date
For Office Use Only Date Paid _______
Date Entered ________
Tier I Code _________
Name ____________________________________ Birthday _____________________ Address __________________________________ City/State _____________ ZIP _______ Phone (home) ___________ (Cell) ___________ Email ____________________________ Emergency Contact Person _______________________________ (Phone) ______________ Member of Tates Creek CC ____ Guest of Tates Creek CC ____
Tier I - individual access ($25 per year) ______
Tier II - group access only ($10 per year) ______
I am interested in receiving regular emails regarding the following LIFE Ministries activities: □ Pickleball □ Basketball □ Zumba □ Martial Arts
If you are a guest, would you be interested in receiving information about the various ministries of TCCC? ____ If yes, which areas?_________________________________________________________________________ I, the undersigned, accept full responsibility for any accident or injury I may incur while occupying and utilizing all equipment and facilities associated with LIFE Ministries and Tates Creek Christian Church. I further accept all equipment for use is as is and agree to pay for any equipment I damage or break not brought about by usual wear and tear. I agree to abide by the rules and policies of LIFE Ministries. Signature
Date
