Island Singles
Hilton Head Island and Bluffton Area
www.hiltonheadislandsingles.com
Membership & Renewal Application
Name___________________________________________________________________
Mailing Address __________________________________________________________
City _____________________________________State __________Zip _____________
Home Phone _____________________________________________________________
Cell Phone ______________________________________________________________
E-mail __________________________________________________________________
Birthday: Month _________________________ Day ____________________________
New Member ________________ Renewal _________________
In consideration of my membership, I hereby agree that neither I, nor my heirs or assigns will hold any member of the club liable for any injury or damage, however caused, that may result from my participation in any club event. Initial ________________
May the club include your information in its directory?
Yes ___________ No ____________
May the club include you in pictures on its website?
Yes ___________ No ____________
Signature _____________________________________________________
Club dues for January 1 through Dec 31 are $25 payable with application.
Dues are not pro-rated and are non-refundable.
Make checks payable to “Island Singles”
Mail to: Sand Ruppert, 2 Juniper Lane, Hilton Head Is., SC 29928
Questions? Call President Bill Krepfle 843.422.5103