Name *

First Name

Last Name

Address *

Address 1

Address 2

City

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Phone *

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Verification *

I verify that I am at least 21 years of age.

As a member of Kilts and Kisses, the Baton Rouge Almost Irish Club, I agree to abide by the rules set forth by the Board. I will represent the club in a gentlemanlike manner at all club functions and during parade activities. I understand that the Baton Rouge Almost Irish Club may deny my application or terminate my membership at any time.

Indemnity & Hold Harmless: As a condition to, and in consideration of, the privilege of your membership in Kilts and Kisses, you, individually and on behalf of your heirs and assigns, hereby agree to assume the risk and responsibility for any and all injuries and/or damages suffered by you that may be caused by third parties or by the negligence or fault of Kilts and Kisses, its agents, officers or directors, during activities of the organization and that you hereby release, indemnify, and forever discharge and hold harmless, Kilts & Kisses its directors, officers, and agents, from any and all responsibility, liability, claims for personal injury, legal actions or suits, damages or losses of any kind or description, arising out of, or in any way connected with, any of the organizations’ activities; moreover, you agree to indemnify, defend and hold harmless, Kilts & Kisses its directors, officers, and agents, from any and all claims of injuries and/or damages suffered by third parties due to your negligence or fault during the organization’s activities.

Date *

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