ALTERNATE UNIVERSES INTERACTIVE LITERATURE ASSOCIATION, INC.
FORCES OF THE EMPIRE
MEMBERSHIP APPLICATION

Please print legibly.  Send this application and your dues (no cash, please) Carla Rodriguez
22671 Garrison St #B1 Dearborn MI 48124

Name:	Birthday:	
Email:

Phone:	Official Use Only
Date received____________
Acknowledgment
Mailed__________________	
Address:	Ph #(        )	
City, State, Zip or out or Country Address
	Amount enclosed	
Renewal?
Yes___________
No____________	Membership type
Regular:                 ___________
Spouse/Roommate:____________	Check #____________________

Money Order#_______________	
	
Membership dues for Forces of the Empire are payable annually on the anniversary date of joining the organization.

REGULAR MEMBERSHIP:			$8.00 US per year
SPOUSE/ROOMMATE MEMBERSHIP:	$2.00 US per year

Regular receive access to the Members only Web Site,  have full voting rights, receive a two dollar ($2.00) discount on the Blaster Battle Role Play participation fee, held at MediaWestCon*, and access to the FOE e-mail lists. Spouse/Roommate members receive the same rights as Regular members.

All applicants, whether new or renewing, must read and sign the following waiver.  If the member is under eighteen (18) years of age, the parent or legal guardian must sign on behalf of the minor applicant.

	I UNDERSTAND THE FORCES OF THE EMPIRE ORGANIZES AND HOSTS LIVE ACTION ROLE PLAY ACTIVITIES.  I AGREE THAT  I DO NOT AND WILL NOT HOLD FORCES OF THE EMPIRE OR ALTERNATE UNIVERSES INTERACTIVE LITERATURE ASSOCIATION, INC., THEIR TRUSTEES, OFFICERS, OR MEMBERS LIABLE FOR ANY INJURY I MAY INCUR WHILE PARTICIPATING IN SAID EVENTS.  BY SIGNING BELOW I BIND MYSELF TO THIS AGREEMENT.

Signature_____________________________________________________Date__________________________

PLEASE LIST YOUR CHARACTERS AND DIVISIONS BELOW/ use extra paper if necessary