Florida Gulf Coast Couples

It's easy to join Florida Gulf Coast Couples, Inc. Simply fill in the on-line form below, click Submit at the bottom, and mail a check for $40 (payable to Florida Gulf Coast Couples, Inc.) to:
Florida Gulf Coast Couples, Inc.
PO Box 13072
St. Petersburg, FL 33733

You will be contacted by the Member Services Couple with your new member kit.

Age requirement: Both individuals must be 21 years of age to join FGCC.

Once you have completed this process, consider if you want to be included in the FGCC Membership Directory. Updated quarterly, the directory is available only to those member couples who request to be included in the directory. You can find the link to filling out that request on the Home Page under Online Membership Directory Submission Please note that joining the organization DOES NOT automatically list you in the Membership Directory which, due to privacy and confidentiality policies, must be initiated by you as a separate process.

ALL INFORMATION WILL BE KEPT PRIVATE AND CONFIDENTIAL.

Applicant 1
Full name:
(Last names are held in strict confidence)
Preferred name for name tag (first name or nickname):
Birthday (month/day):

Applicant 2
Full name:
(Last names are held in strict confidence)
Preferred name for name tag (first name or nickname):
Birthday (month/day):

Email
Email is our primary mode of communication to notify members of events and other important information.
Please indicate your preferences.
Email both of us at this primary address:
In addition, email a copy to this address:

Mailing Address
Street:
City: State: Zip:

Phone Numbers
Primary #: Area code Number
Alternate: Area code Number

Your Anniversary: Month Day Year

Referred by, if applicable:

We learned about FGCC through:

Waiver and Participation Agreement
We, the applicants listed above, are aware that our participation in the activities of Florida Gulf Coast Couples, Inc. (FGCC) may involve potential risks of injury, and we are voluntarily participating in such activities with that knowledge. We acknowledge that we will use our own best judgment to avoid injury to ourselves and others. We agree to abide by the rules of public venues at which FGCC activities are held. In consideration for FGCC's membership services, we release FGCC, including its board of directors and officers, activity leaders, event hosts, and other FGCC representatives, from any liability for injuries to our person or property resulting from our participation in FGCC activities. We further agree to hold harmless and indemnify FGCC and said representatives against any claims, liabilities, lawsuits, attorney fees, or costs to which they may be subject due to our acts or omissions in connection with FGCC activities. Our initials below indicate our agreement to the above terms.
Applicant 1 Initials: Applicant 2 Initials:

Photograph Consent
We consent to being photographed at FGCC events for posssible publication in the newsletter and on the website.
YES or NO:

Please note any comments you would like to make:

Your membership will not become official until your check is received.

Florida Gulf Coast Couples, Inc. PO Box 13072 St. Petersburg, FL 33733

Florida Gulf Coast Couples, Inc.
PO Box 13072
St. Petersburg, FL 33733