Harvard Family Association (HFA) Membership Form

September 2006-June 2007

New Member _________________

Renewal _____________________

Change of information __________

Parent Names: _________________________________________________________________________________________________________

Address: _____________________________________________________________________________________________________________

Telephone: _________________

Email Address: __________________________

Name of child(ren)                                                                    Date of Birth

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

I hereby absolve the Harvard Family Association fo any liability at HFA sponsored events

(please sign) __________________________________________________________________________________

Annual Dues (September 2006-June 2007)       $25   ($15 after February 2007)

Make check payable to the Harvard Family Association and mail to:

                        Harvard Family Association

                            PO Box 544

                         Harvard, MA 01451

Check if you are willing to help with or host an HFA event

Halloween Parade Committee ________                    Play Groups ________

Spring Egg Hunt _________                                        New Baby Event (spring) _________

Organize Mom's night out ________                            I'm Flexible - call me ________

Would you like ot have your newsletter sent via email? __________

If you think you might be interested in holding an HFA officer role, please contact Kate Squire or Betsy Starr for more information. We'd love to have you!