The Center for Sixteenth Century Studies
c/o Ed Pounds
P.O. Box 1250
Wofford Heights, CA 93285

Membership Application Date:__________________

Last Name First name MI. Mailing Address for each joining family member

1.______________________________________________________________

2.______________________________________________________________

3.______________________________________________________________

4.______________________________________________________________

5.______________________________________________________________

6.______________________________________________________________
(for additional names, use another application)

Public or Private Faire name(s) or Biggins Name(s) for each joining family member.

1.___ ____ ______________________________________________

2.___ ____ ______________________________________________

3.___ ____ ______________________________________________

4.___ ____ ______________________________________________

5.___ ____ ______________________________________________

6.___ ____ ______________________________________________

Would you like to be designated as an official Biggins’ Warehouse
No______Yes______

Communication (optional)
Telephone Cell Phone/pager E-mail Fax

1.______________________________________________________________

2.______________________________________________________________

3.______________________________________________________________

4.______________________________________________________________

5.______________________________________________________________

6.______________________________________________________________


Describe your faire persona(s) (Optional)

_______________________________________________________________

_______________________________________________________________

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Attach a favorite faire photo (optional)

Do you ave any special skills, which can help the organization?ASL, Foreign language, musical talent, theatrical makeup, computer skills, artistic talent, sewing, etc.

1.______________________________________________________________

2.______________________________________________________________

3.______________________________________________________________

4.______________________________________________________________

5.______________________________________________________________

6.______________________________________________________________

Annual Dues
_____Adults/Individuals X $25.00 = ____________ Cash or Check #________
_____Child/Student X $10.00 = ____________ Payable to:
_____Family X $50.00 = ____________ The Center for Sixteenth
Century Studies

HOLD HARMLESS AGREEMENT

Mirepoix, Inc. reserves the right to refuse membership to anyone with or without cause. Member and Mirepoix, Inc. agree to hold harmless each other in case of any real or perceived or imagined conflict.

Signed:________________________________

Date:__________________________________