Membership dues are $25.00 for the first member of a household, $15.00 for the second member and $10.00 for all remaining members,  (plus a one time household initiation fee of $15.00)  As always, you can use this as a gift for a relative or friend.  Please fill out and return all  information, even renewing members, it  allows us to verify and update our files. You may also select having your information printed in the annual mailing list. Thank you for your cooperation.

Name ________________________________________________________________________

Name ________________________________________________________________________

Name ________________________________________________________________________

 if you have additional names, please list them on the reverse of this form

Address ________________________________________Phone _________________________

City _________________________________ State ___________ Zip _____________

Email Address __________________________________________________________

Print Name on General Member Distributed Mailing List?   Yes ______ No______

DODGERS BOOSTER CLUB INC. RELEASE AGREEMENT WAIVER

As a member of the Dodgers Booster Club, Inc. (hereafter referred to as DBC I / we agree as follows: DBC is a non-profit corporation organized for the mutual enjoyment of its members in supporting the Los Angeles Dodgers Baseball Club.

The Dodgers Booster Club, Inc.'s activities may include group transportation to/from baseball games, meetings, picnics, and other events.  At these events, the Dodgers Booster Club, Inc., may serve food and engage in group activities of various type.

I (we) understand that the activities of DBC would not be possible if the organization were to accept responsibility for injury to its members or losses its members might incur while participating in group activities, eating, travel or otherwise.

Therefore, I (we) agree to waive any claims that I (we) now have or ever may have arising from my (our) participation in DBC and to release and hold harmless the Dodgers Booster Club, Inc., together with its officers and directors, from any liability whatsoever for any injury or damage that I (we) may sustain as a result of participating in events sponsored by the Dodgers Booster Club, Inc.

This agreement shall bind & apply to the benefit of my heirs, representatives, or estate and to the successors of DBC.

Member Signature _________________________________________D.O.B._______________________

Member Signature _________________________________________D.O.B._______________________

Member Signature _________________________________________D.O.B._______________________

Additional members please sign on reverse of this page

Please PRINT NEATLY and fill out completely • Use reverse side for additional names • Mail to: 

Membership • Los Angeles Dodgers Booster Club • P.O. Box 86964 • Los Angeles, CA  90086