NORTH CAROLINA A&T STATE UNIVERSITY CHAARG MEMBERSHIP

$ 57.00

We are so excited for you to join CHAARG! Need more information before you join? Find that here!

By purchasing this membership, you are agreeing to the terms of the “CHAARG Membership Contract,” which can be viewed here, + the “CHAARG Liability Waiver,” which can be viewed here. You will receive a confirmation email within 24 hours of your purchase [it looks like a receipt!].

First name*:

Last name*:

Email*:

Phone*:

Year*:

When is your birthday? MM/DD/YY*:

How long have you been a member of CHAARG?*:

Instagram handle*:

What are your pronouns?*:

What is your racial or ethnic identity?*:

Do you have any medical conditions // allergies?*:

Emergency contact name*:

Emergency contact relationship*:

Emergency contact phone number*:

Emergency contact email*:

Digital signature for CHAARG Accident Waiver // Release of Liability*:

Quantity