Printer Friendly Piedmont Swing Dance Society, Inc. Membership Form The Piedmont Swing Dance Society, Inc. is a nonprofit, volunteer organization dedicated to the promotion of swing dance in the Triad and surrounding communities. PSDS, Inc. members receive reduced admission to PSDS, Inc. events. Annual Jitterbug Membership: $20.00 Checks only. Make payable to: PSDS, Inc. Mail to: PSDS, Inc. PO Box 39354 Greensboro, NC 27438 Name__________________________________________________________________________ Address________________________________________________________________________ City________________________________State________ Zip________________ Home Phone_____________________  Work Phone _________________________ E-mail________________________________ Organization / School___________________________________________________ Occupation________________________________________________________________   Age: ___Under 18 ___19-22 ___23-29 ___30-39 ___40-49 ___50-64 ___Over 65 How did you originally hear about the Piedmont Swing Dance Society, Inc.? ___Friend ___Co-worker ___Triad Style ___Newspaper ___Flyer ___Other_______________ In consideration of mutual benefit derived from membership in the Piedmont Swing Dance Society, Inc., acknowledging that an injury may occur while dancing, the undersigned does hereby assume all risk and absolves, releases and waives any and all liability claims or demands against the Piedmont Swing Dance Society, Inc., its officers, directors, and each and every member thereof which may arise out of an act related to an injury. Signature________________________________________________  Date________________