Membership Form

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Single Gourmet

 3840 West Hillsboro Blvd. #122

Deerfield Beach, Fl 33442

Click on the green button above to print out a printer friendly Membership Form, fill out all pages and mail with a check or money order for the membership fee of $99. (One year) or $149. (Two Years) to our Corporate offices at the address listed above to get started with Single Gourmet.

Name: ______________________________________________________

Address: ____________________________________________________

Bldg. # ________________________ Apt. # _______________________

City: __________________________ State: __________ Zip: _________

Home Phone # _______________________________________________

Work Phone #  _______________________________________________

Cell Phone #    _______________________________________________

E-Mail Address _______________________________________________

Current Marital Status:

(   ) Never Married    (   ) Separated     (   ) Divorced     (   ) Widowed

(   ) Male                   (   ) Female

Date of Birth:________________________________________________

Circle Age Range You Wish To Be Seated In – Please Be Realistic

21+              25+              30+              35+              40+              45+

50+              55+              60+              65+              70+              75+

Membership:  (   ) One Year - 99.  (   ) Two Years – 159. (Save $50.) 

How did you hear about us: ____________________________________

Occupation: __________________________________________________

Employer:    __________________________________________________

Date:   _______________________________________________________

Signature:   __________________________________________________

Serving all of the South Florida tri-county area.

Broward County   Palm Beach County   Miami-Dade County

  954-723-9608         561-276-2595            305-371-8717

 

Who may attend events:  The South Florida chapter of The Single Gourmet consists of three individual chapters. Broward County, Palm Beach County and Miami-Dade County.  Each area has its own events, but as a courtesy, we do show the listings of all three areas in our monthly newsletter.  If a member would like to attend some events in another county, they are certainly welcome.  If they choose to attend events only in their county, that’s OK too.  Only members of the The Single Gourmet may attend. 

Other Single Gourmet cities nationwide:  As a member of The Single Gourmet, you are entitled to use any of The Single Gourmet chapters nationwide and in Canada.  If you plan on traveling to any Single Gourmet city, please contact our office before you leave on your trip.  You will need a letter of introduction confirming that you are a member in good standing in the South Florida chapter of The Single Gourmet.
 
Referrals:  If you refer a friend or family member who joins our private dining out club for singles, you will receive a two month extension on your yearly membership.  The member’s name must be written on the membership application as the referring party.
 
Professional and moral standards:  All members must at all times act in a courteous manner.  The Single Gourmet will not tolerate any behavior that is not in good taste.  Any member (at the discretion of the directors of The Single Gourmet) will be asked to leave an event if it is determined that the member in question is not acting in a courteous manor.

CONSUMER’S RIGHT OF CANCELLATION: YOU MAY CANCEL THIS CONTRACT WITHOUT ANY PENALTY OR OBLIGATION WITHIN 3 BUSINESS DAYS FROM THE ABOVE DATE, AND RECEIVE A FULL REFUND OF ALL PAYMENTS MADE TO THE SELLER. YOU MAY ALSO CANCEL THIS CONTRACT UPON A DOCTOR’S ORDER YOU CANNOT PHYSICALLY RECEIVE THE SERVICES, OR YOU MAY CANCELTHE CONTRACT IF THE SERVICES CEASE TO BE OFFERED AS STATED IN THE CONTRACT. IF YOU CANCEL THE CONTRACT FOR EITHER OF THESE REASONS, THE SELLER (THE SINGLE GOURMET) MAY KEEP ONLY A PORTION OF THE CONTRACT PRICE EQUAL TO A PRO RATA PORTION OF THE TOTAL PRICE REPRESENTING THE PROPORTION OF SERVICES YOU USED OR COMPLETED, PLUS THE COST TO THE SELLER OF ANY RELATED GOODS WHICH YOU CONSUMED OR RETAINED. THIS CONTRACT OR NOTE IS FOR FUTURE CONSUMER SERVICES AND PUTS ALL ASSIGNEES ON NOTICE OF THE CONSUMERS RIGHT TO CANCEL UNDER CHAPTER 2-18, FLORIDA ADMINISTRATIVE CODE.

E-Mail Announcements:  The Single Gourmet will periodically send you e-mail calendars of events, updates or specific advertising about The Single Gourmet.  By becoming a member of The Single Gourmet you agree to receive our e-mail.  You may opt-out at any time by e-mailing us at SingleGourmetFla@aol.com

Signature _________________________ Date ___________ 

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