Join TSB – Tucson Society of the Blind

Membership Information

Please complete the member information and emergency contact sections below. Once accepted, you will need to pay your dues of $18, which includes Paypal fees.

Name *

First

Last

Street Address *

City *

State *

Zip Code *

Primary Phone *

Alternate Phone

Email *

Birthday

Spouse's Birthday

If you have any allergies to medicines, please list them here

EMERGENCY CONTACT *

Please enter the name of your emergency contact here

Emergency Contact Primary phone *

Emergency Contact Alternate phone

BACKUP CONTACT

Please enter the name of your alternate emergency contact here

Alternate emergency phone

ACTIVITY WAIVER - enter your electronic signature *

ACTIVITY WAIVER I understand that I participate in all activities, programs, fund raisers, and field trips offered by Tucson Society of the Blind TSB), at my own risk. I verify and acknowledge the risks involved in participating in TSB activities, programs, fund raisers, and field trips. I release and discharge TSB and its Board of Directors from all claims, damages, injuries, actions, or demands, what so ever in any matter relating to participating in activities, programs, fund raisers, or field trips of TSB.

current date *

Please enter today's date.

Questions? Reach us by phone:

Barbara Macpherson, President
(520) 298-2427