Printable Form

P O Box 610314
DFW Airport, TX 75261

Membership in Dinner-Match has its privileges:

1. You are given a period of 3 days to register and pay for that dinner before the dinner is opened to the general public.

2. You pay a discounted registration fee for each event.

Membership does NOT guarantee any member can attend every dinner.

Membership does NOT guarantee any member can attend a certain number of dinners during membership time.

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I am joining Dinner-Match for four months from the date of today. 

Today's date: ____/ ____/ ____ 

Email Address : ________________________________________
Most correspondence is by email. Please print so we can read it.

Day Phone:  (__________) ___________________________
Week-end Phone:  (__________) ______________________

___ Male   ___ Female

Check number: ________________ 
Amount Paid: $______________ 
     Pay $59 for four months membership from date of today.

By joining Dinner-Match, I hereby release and hold Heart Express and SOLO for Singles, their owners, agents, and employees harmless from any and all claims and damages, whether it be caused by myself, by any other person, or by the ordinary negligence of Heart Express, SOLO for Singles,  their owners, agents, or employees. I realize that membership does not guarantee a certain numbers of dinners during my membership time nor does it guarantee that I can attend every dinner. Members are given a period of time to register and pay for that dinner before the dinner is opened to non-members and the general public. The registration fee is discounted for members.

Signed ___________________________
Please print:
Name: ___________________________________________

Address:  ________________________________________ 

Suite/Apt ____________

City: _______________________ State _____  Zip_______

Print, fill out and mail form with check. Make check payable to Singles and mail to Singles, P O Box 610314, DFW Airport, TX 75261.