Membership Consent Form

MEMBERSHIP CONSENT FORM

WHEREAS

WHEREAS, Organization Name: (the "Organization") administers membership programs that provide access to certain services, events and benefits to eligible members; and

WHEREAS, Member Name: seeks to enroll and participate in the Organization's membership program and hereby agrees to the terms and conditions set forth in this Membership Consent Form;

NOW, THEREFORE, in consideration of the mutual covenants contained herein and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

Member Information

Scope of Membership Benefits

The Organization agrees to provide the member with the benefits, privileges and services described below. The scope below sets forth the primary obligations of the Organization to the member and any conditions that apply to use of those benefits.

Payment Terms

Member agrees to pay membership fees in accordance with the schedule and amounts set forth below. All fees are non-refundable except as expressly provided in this Agreement.

If payment is not received within the time provided in the billing schedule, the Organization may assess the late payment charge set forth above and may suspend membership privileges until payment in full is received. The member is responsible for all collection costs, including reasonable attorney's fees, for delinquent accounts.

Term and Termination

This Agreement commences on Start Date: and continues until End Date: unless earlier terminated in accordance with this section.

Either party may terminate this Agreement for convenience by providing the other party with written notice at least the number of days set forth above. Termination for cause is permitted where the other party materially breaches any obligation under this Agreement and fails to cure such breach within thirty (30) days after receipt of written notice of the breach.

Confidentiality

The member and the Organization each acknowledge that, in the course of performance under this Agreement, they may receive confidential, proprietary or non-public information of the other party ("Confidential Information"). Each party agrees to hold Confidential Information in strict confidence, to use it only for purposes of performing obligations under this Agreement, and not to disclose such information to any third party except to employees, contractors or agents who have a need to know and who are bound by confidentiality obligations no less protective than those set forth herein. Confidential Information does not include information that is or becomes publicly available through no fault of the receiving party or that is independently developed by the receiving party without reference to the disclosing party's Confidential Information.

Consent, Release and Member Obligations

The member consents to comply with all published policies, rules and codes of conduct of the Organization as may be amended from time to time. The member authorizes the Organization to use the member's name, likeness and testimonial in promotional materials related to the Organization, unless the member affirmatively declines by initialing next to the following statement:

I consent to use of my name and likeness by the Organization.

By signing below, the member releases the Organization and its officers, directors, employees and agents from any liability for incidental, indirect, special or consequential damages arising from the member's participation in membership activities, except to the extent caused by gross negligence or willful misconduct. This release does not waive statutory rights that may not be waived.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to principles of conflict of laws. The parties submit to the exclusive jurisdiction of the state and federal courts located in that State for resolution of disputes arising under this Agreement.

Entire Agreement

This Agreement, together with any attachments, schedules and written policies expressly incorporated herein, constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements, understandings and representations, whether written or oral. Any modification or waiver of this Agreement must be in a signed writing by both parties.

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