Get Membership Form
Please print out this 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 below to get started with Single Gourmet.
Single Gourmet
5379 Lyons Road #431
Coconut Creek, Fl 33073
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 – 149. (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 Single Gourmet may attend.
Other Single Gourmet cities nationwide: As a member of 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 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. Single Gourmet will not tolerate any behavior that is not in good taste. Any member (at the discretion of the directors of 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: Single Gourmet will periodically send you e-mail calendars of events, updates or specific advertising about Single Gourmet. By becoming a member of 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 ___________
Single Gourmet
5379 Lyons Road #431
Coconut Creek, Fl 33073
