
<p> JOIN THE KREWE Membership Application</p><p>Full Name: ______Address: ______Spouse (if applying also): ______City: ______E-Mail Address: (self) ______State: ___ Zip: ______E-Mail Address: (spouse) ______Home Phone: ______Cell Phone: (self) ______Cell Phone: (spouse) ______Birth Date: (self) ___/___/___ (mm/dd/year) Birth Date: (spouse) ___/___/___ (mm/dd/year) Work Phone: (self) ______Work Phone: (spouse) ______</p><p>I/We understand that joining the Krewe of Gemini will require the non-refundable payment of the designated dues and fees noted above upon acceptance. The Krewe of Gemini prohibits underage drinking. Any member found to be in violation will be subject to being immediately denied continued membership. Upon submission of this application, I/We agree to abide by all Krewe of Gemini rules and regulations.</p><p>(5% Credit Card Processing Fee will be added to above fees for Members choosing to pay in full via credit card)</p><p>_____ VISA _____ MC ACCOUNT NO: ______</p><p>EXP. DATE: ______(MO/YR) SECURITY CODE: ______(3 DIGITS ON BACK)</p><p>PRINT NAME AS APPEARS ON ACCOUNT: ______</p><p>SIGNATURE OF CARD HOLDER: ______</p><p>Complete this section if you are also making application for Children Riders: Name: ______Birth Date: ______Grade at Time of Parade: ______Name: ______Birth Date: ______Grade at Time of Parade: ______Name: ______Birth Date: ______Grade at Time of Parade: ______</p><p>Sponsoring Member(s) Name(s): ______</p><p>(Sponsor not required for application purposes)</p><p>Mail Application and Payment (check or credit card) to: Krewe of Gemini 2241 Landau Lane Bossier City, LA 71111 Revised: 5/13/2017</p>
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