2011-2012

KREWE OF MASSALINA
MEMBERSHIP APPLICATION MARCH 2011 FEBRUARY 2012

2011-2012

The Krewe of Massalina, Inc., a not-for-profit Florida corporation, is a social/charitable club organized with the intent of contributing to Bay District Schools and other community organizations, participating in the Panama City, Florida, Mardi Gras celebration, and HAVING FUN. The Krewe has a Board of Directors and By-laws, which govern the business activities of the Krewe on behalf of its membership. Current Krewe membership dues are $75 per year for full members; these dues cover the period from payment through the February 2012 parade and include the following benefits: Mardi Gras parade ride, all Krewe social events, and a newsletter subscription. Membership is open to all individuals who are at least eighteen years old. Associate member dues are $50 per year and include all benefits EXCEPT the Mardi Gras parade ride. Please complete (printing would be appreciated) the following contact information, sign the form, enclose your check made payable to THE KREWE OF MASSALINA for the full amount and mail it to the address listed below. Name: ________________________________________________________________________ Mailing Address: ________________________________________________________________ City: ____________________________________ State: _______________ ZIP: ___________ Home Phone: ___________________________________________________________________ Work Phone: ___________________________________________________________________ E-mail address: _______________________________________________________________________ I understand that by completing this membership form and paying dues, I agree to and expressly undertake to indemnify and save harmless the Krewe of Massalina, Inc., its directors, officers, members, employees, agents, successors and assigns from any and all losses, personal injury, or damages of any type incurred by me which result from or arise out of membership in the Krewe of Massalina, Inc., or participation in the activities of the Krewe of Massalina, Inc., whether said damages are caused by the negligence of Krewe of Massalina, Inc., its directors, officers, members, employees, agents, successors and assigns or otherwise.

Signature: ________________________________________Date:________________________
Check appropriate box (es): I am applying for full membership. I am applying for associate membership. I am also a new member for 2011-2012, and ________________________gets credit for recruiting me.

Please return your signed form and your payment to: Krewe of Massalina, P. O. Box 347, Panama City, Florida 32402- 0347. If any concerns please contact us at 850-913- 8383 or www.Pckrewe.com