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ANAHEIA1 SEl\TfORCITlZEiVS CLUB, INe 250 E CENTERAVE.,AJ'y~IIEIM, CA 92805-3205 PI/ONE: 1-[PHONE REDACTED] APPLICATION FOR MEMBERSHIP Any person 50 years or over may join ASCC. Ten dollar ($10.00) dues are for calendar year. Date you originally joined ASCC _ Memberships expire on December 31st., regardless of the actual date you joined. Dues are not prorated. PRINT NAME.~ _ Last Name Renewa! Date Card # ~ First Mid(!1$ Initial HOME I MAILING ADDRESS. . _ Apartment # Space # _ CITY . STATE ~ 9 Digit Zip Code - _ TELEPHONE CeHlHome; _ EMAIL ADDRESS:' _ 00 you wish to receive the Courier? _ I am willing to volunteer. when called, for the following: Decorations Casino Day (June) Food Service Setup Kitchen Helper Receptionist Holiday Boutique (Fall) Gift Shop Aide Membership Travel Dept. Aide Computer- Literate Aide Additional Information: _ Birthday:~~~-= ~ Month - Day - Year Friendly Phone Calls Cook Advertising Aide Newsletter Aide Entertainment (type) IN CASE OF 'EMERGENCY Pl~ASE CALL _ HOME PHONE CEUJWORK PHONE REtATION, TheAnaheim Senior Citizens Club; akaASCC, its Executive Board Members and activity leaders strive to enhance seniors quality of life by offering an opportunity to travel, promoting good hearth, and by fostering social interaction and independence. ' In exchange for the benefits received from my participation in the Anaheim Senior Citizens Club and its activities I HEREBY AGREE TO INDEMNIFY AND HOLD HARMLESS THE ANAHEIM SENIOR CITIZENS CLUB, ItS EXECUTIVE BOARD MEMBERS AND VOLUNTARY LF.J-\DERS, from any and all liability from \lvhatever source, eXGeDtinq only intentional torts, which arise from, or in connection with, my participation in the Anaheim Senior Citizens Club and its activities. Date Your Signature