Membership Type: If you are a new member, who referred you / how did you learn about SIW?

Yes, I have read, understand and agree to the "Release and waiver of liability, assumption of risk, indemnity and parental consent agreement."
(Type your initials in this box to indicate your agreement.)

Member: First Name: Last Name: E-Mail:
Birth Month & Day: Gender:
Street Address: City: State: Zip Code:
Home Phone (with area code): Cell Phone (with area code):

Family: Spouse: First Name: Last Name: E-Mail:
Birth Month & Day: Cell Phone (with area code):

Child 1: First Name: Last Name: Birth Month & Day:
Child 2: First Name: Last Name: Birth Month & Day:
Child 3: First Name: Last Name: Birth Month & Day: