Lake Cumberland Corvettes, Inc

LAKE CUMBERLAND CORVETTES, INC.

SOMERSET, KENTUCKY

www.lakecumberlandcorvettes.com

2015 Membership Application

Initial membership dues are $50.00 to join the Club. You will receive a “New Member Packet” that includes a copy of the by-laws and other materials the Club may supply at the time of membership confirmation.

Renewal membership dues are $35.00 per membership per year.

Date of Application ______

Applicant’s Name ______Birthday______

Spouse’s Name ______Birthday______

Anniversary Date ______

Address ______

City ______State______Zip______

Home Phone ______Cell # ______

Email Address ______

Corvette Description (1) Year______Color______Type______

(2)  Year______Color______Type______

PLEASE PROVIDE A PICTURE OF YOUR CAR WITH THIS APPLICATION.

PLEASE SEND TO: CINDY STRINGER, Club Secretary / Treasurer

P.O. Box 3751

West Somerset, KY 42564

LAKE CUMBERLAND CORVETTES, INC.

GENERAL RELEASE

For good and valuable consideration, receipt of which is hereby acknowledged, the undersigned jointly and severally release, discharge, acquit, and forgive Lake Cumberland Corvettes, Inc. now and forevermore, from any and all claims, actions, suits, demands, agreements, liabilities, and proceedings of every nature and description, whether at law or in equity, arising from the date of this release.

This release shall be binding upon and inure to the benefit of the parties, their heirs, successors, assigns and personal representatives.

Signed this ______Day of ______20____

Signature ______

Signature ______