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Brew City Bears Of Milwaukee, WI

Membership Form

Please complete the fields below and we will respond to your inquiry within 48 hours.

Brew City Bears
e-mail: ajr2cook4u@gmail.com
P.O. Box 1035
Milwaukee, WI 53201-1035
Phone (414) 331-3744 (Alan)

I , The undersigned , Do agree and understand that I will not now , nor at anytime during my membership in the brew city bears (bcb) hold the bcb, its directors, members, or any other entity associated with the bcb liable for any type of injury., physical or otherwise, which I may sustain as a result of my participation with the bcb. I further assume responsibility for my own actions. I certify that by checking the box below i am affixing my signature. I certify that I am at least 21 years of age or older and release the bcb , its directors, members and other entities associated with the bcb from any and all liabilities arising from publications in newsletters, personal advertisements,, or the bcb web site. The club will bill you for the annual dues of $20.00

Membership authorization	Check here to join the club
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
This is if you do not want to be listed on the membership roster available to other club members	check this box for unlisted information
todays date:
checking this box is affixing your signature to the terms listed above	click to agree to terms listed above
If you prefer not to receive e-mail notification of club business	check this box for snail mail
Yahoo Group membership	Check this box to join the clubs yahoo group
Tell us about yourself:
Birthday Month and Day only:

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