Membership Application

Members of the First Coast Shag Club started the Jacksonville Junior Shaggers in 2014 in order to teach Carolina Shag to future generations. We are honored to have your junior join our group. It is our goal to provide a fun, exciting, safe, learning and social experience. We thank you for giving us this opportunity and appreciate your participation. All of our events are free for juniors. Kids love to dance with their family members and we encourage you to participate in all of our activities. You are responsible for the behavior of your child at our events. We expect them to behave like young ladies and gentlemen and expect them to treat everyone with courtesy and respect. They may bring their friends to any of our events as long as they are under 21.

Junior's Full Name

First Name

Last Name

Junior's Birthday

MM

DD

YYYY

Junior's Email Address

Junior's Cell Phone

(###)

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Junior's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

As a member of the Jacksonville Junior Shaggers I will be friendly to everyone, treat everyone with kindness and respect, and be willing to teach others what I have learned. I will not drink any alcohol or use drugs or cigarettes at any Jr Shag event, nor will I bring them with me, or offer them to another person. I understand that photos and videos may be taken during the events and agree to let Jacksonville Junior Shaggers post those photos and videos on the web, Facebook, and in e-mails to members. I also agree to their use in promoting the Jacksonville Junior Shaggers

I agree

Guardian's Full Name

First Name

Last Name

Relationship to Junior

Guardian's Email

Guardian's Cell Phone

If no cell phone is available, please add a home or work phone.

(###)

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####

Guardian's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

As the guardian of the junior listed above, I give my permission for him/her to join the Jacksonville Junior Shaggers and to participate in their events. I understand that photos and videos may be taken during the events and agree to let Jacksonville Junior Shaggers post those photos and videos on the web, Facebook, and in e-mails to members. I also agree to their use in promoting the Jacksonville Junior Shaggers. I agree that I will not provide alcohol, drugs , or cigarettes to any of the juniors while at any of the events. I understand that I am responsible for the behavior of my junior at all events.

I agree

If you'd prefer to print this application, you can download it here. Applications can be scanned or photographed and emailed to jaxjrshaggers@gmail.com.