Dual New Membership Application

1. Last Name:

First Name:

2. Last Name:

First Name:

If you don't always travel with the same person, list the 2nd Last Name as "Companion".

Tell us about your location...

Street:

Apt./Unit:

City:

State/Province:

Zip/Postal Code:

Country:

Telephone:

E-mail Address:

Fax (optional):

Places and activities of possible interest to those who visit your area:

Tell us about yourself...

Employment:

Full-time Part-time Retired

Your Profession:

Your interests/hobbies:

Tell us about your accommodation...

Dwelling:

Single Family Condo/Apt Modular

Number of Guests:

1 2 3 4+

Bed Types:
(Check all that apply)

King
2 Twin

Queen
Single

Double
Non-standard

........................................

Bathroom:
(Check all that apply)

Private

Shared

........................................

Home Environment:
(Check all that apply)

A/C

Non-smoking

Pets

Tell us about your hospitality...

Breakfast Served:

Continental Full Guest Preference

Your Availability:

Overnight only Overnight + daytime ok

Restrictions:
(Check all that apply)

No children
No pets

No unmarried or
same sex couples

........................................

Special Amenities:
(Check all that apply)

Laundry privileges

Kitchen
privileges

RV parking

........................................

Additional Services:
(Check all that apply)

Sightseeing

Transportation

Home cooked
dinners

........................................

I would be
interested in:
(Check all that apply)

Dining out with guest (Dutch treat)
Exchanging homes for vacation purposes
Traveling with an Evergreen Club member with similar interests

Show us your home...

A recent photo of your home must be attached in order to process your application. Please attach a digital photo of your home here:

Membership Terms...

I verify that I am at least 50 years of age and that the information on this application is true to the best of my knowledge. I agree to provide bed & breakfast for Evergreen Club members to the best of my ability, and there will be no charge except for a modest gratuity of $10 a day for one person (or $15 a day for two) to defray any out-of-pocket expenses I may incur. I will make every effort to maintain good relations with fellow members. I understand that I am solely responsible for making arrangements with the Evergreen Club members whom I wish to visit, and that the Evergreen Club provides no warranty as to the accommodations or conduct of its members. I agree to hold harmless the Evergreen Club from all liability that may arise from my participation as a member. I understand that membership materials will reach me within 3 to 5 business days. By clicking the button below, I am agreeing to these Membership Terms and I am submitting my application for membership.