Livermore Mom's Club - Join Online!

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Membership:
Renew Online - Member Information

Completing the form below online is the fastest way to active LM benefits, but we also provide the paper forms in the box on the right. You can pay online using our PayPal portal and send us the paper form, or fill out the form online and mail your check. Whichever way makes you most comfortable is fine with us. Just let us know. Contact Membership with any questions.

Want to use paper forms instead?

Member Renewal Form (PDF)

Questions? Contact
membership@livermoremoms.com

Step One:
Please complete the following information:
Your membership will not be active until both this member information and payment are received.

Member Information:
Member Status:	New Member Existing Member Renewal (if you have been a member in the last 12 months)
* First Name:		* Last Name:
* Phone Number:		Date of Birth: (optional)	Month & Day (year not needed)
* Street Address:		* Email Address:	For monthly e-newsletter & club activity notification.
* City, State & Zip:		Yahoo! ID:	For the club Yahoo!Group chat board.
Your Occupation: (optional)			Your Yahoo! ID may or may not match your email address. What is a Yahoo! ID?
Family Information:
* Spouse/Partner Name: (optional)
* Child 1. First Name:		Child 1. Birth Year:
* Child 2. First Name:		Child 2. Birth Year:
* Child 3. First Name:		Child 3. Birth Year:
* Child 4. First Name:		Child 4. Birth Year:
* Child 5. First Name:		Child 5. Birth Year:

The following information is published in our member directory, which is password protected and is only viewable by our current membership. Please check only the boxes that you do NOT want to appear in the directory, if any:
Name Phone Number Email Address Name of Children & Year of Birth

Please tell us where you learned of the Livermore Moms:

Livermore Moms Waiver/Release/Indemnity Agreement:

Definitions:
“LIVERMORE MOMS” includes but is not limited to the LIVERMORE MOMS, its officers, Executive Board, Directors, members, agents, employees, attorneys and/or insurers.

Intent & Purpose:
The purpose of this agreement is to allow me and my family members to participate in the functions and activities of the LIVERMORE MOMS (“LM”).

Waiver/Release/Indemnity:
I understand that the LM requires me to be responsible for the safety and conduct of my family, my guests, and myself while participating in all LM activities. I also understand that the LM requires all other members to be similarly responsible for themselves, their families and their guests. I therefore make the following agreements:

I release the LM from any obligations or duty of care owed to me, or to any individuals for whom I am responsible;
I waive any and all liabilities or claims I may have or individuals for whom I am responsible may have, against the LM for personal injuries or property damages arising out of our participation in LM functions or activities connected to the LM, including liability for the negligence of the LM, its Executive Board, sponsors, representatives, or members;
I agree to indemnify the LM for any and all liabilities and claims arising from my own conduct or negligence, or the conduct and negligence of individuals for whom I am responsible;
I give permission for photographs and/or video recordings of myself, my family members, and my guests to be used for publicity or in publications or presentations relating to LM and its programs. I also give LM permission to use the photographs to create an online and physical scrapbook;
I accept that my participation in any LM function will be voluntary and I assume all risks related to my participation and activities connected with the LM, and all such risks to individuals for whom I am responsible.
I accept on behalf of myself, heirs, beneficiaries, assigns, agents, child or children, wards, next of kin, successors and/or conservators any and all risk(s) as well as responsibility for any resulting personal injury (including death) and/or property damage.

Warranties:
I acknowledge that the LM makes no warranties regarding insurance coverage for any member, participant, host, sponsor, or facilities connected with LM activities and functions.

Term:
I agree that this release shall be effective as long as I participate in activities connected to the LIVERMORE MOMS, regardless of membership.

I am officially signing the membership form and agree to all rules, regulations and policies outlined in the
LIVERMORE MOMS BYLAWS and LIVERMORE MOMS Privacy Policy.
I knowingly accept the Release of Liability after having read and understood the terms.

Date of Agreement:

Your membership will not be active until both this member information and payment are received.