DMFC Membership Form

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Des Moines Fencing Club Membership Form
(please print all information)

Last Name: _________________________ First Name: __________________________

Address: ________________________________________
________________________________________

City, State, Zip: _________________________________________

Phone Number: ____________________ Email Address: _________________________

Birthday: _______________

Emergency Contact: ________________________________________________
________________________________________________
________________________________________________

Is there a medical condition that anyone needing to administer first aid should know about? If so, please explain. This information is kept confidential.
________________________________________________________________________
________________________________________________________________________
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Rules of the Club:

Substance abuse is not tolerated at the Des Moines Fencing Club or any of its functions. Anyone caught will have his or her membership terminated and barred.

Any member not following the fencing safety rules as outlined by the USFA may face disciplinary actions up to and including termination of their membership at the discretion of the Board of Directors.

Behavior that is rude, disrespectful, disruptive and/or hostile will not be tolerated by any member or guest of the DMFC and will result in disciplinary action by the Board of Directors ranging from being asked to leave the practice, suspension of membership for a month or termination and barring of membership, depending upon the severity and frequency of the offences.

As a member, you are required to maintain an active membership with the USFA. Failure to do so will result in your membership being suspended until you comply

Waiver of Liability:
Upon entering practices and/or events sponsored by the DMFC, I agree to abide by the rules of the DMFC and the USFA, as currently published. I understand and appreciate that participation in a sport carries a risk to me of serious injury, including permanent paralysis or death. I voluntarily and knowingly recognize, accept and assume this risk and release the DMFC and the USFA from any liability.

Signature: ___________________________________ Date: __________________

Parent or Guardian (under 18): ________________________ Date: _______________
This information is for club use only and will not be shared with anyone not a member of the Board of Directors of the Des Moines Fencing Club

Last updated 7/26/06