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Membership & Date Request
Thank you for taking the time to join Eight on a Date.
Please fill out the following questionnaire fully. After you
have filled out the questionnaire once, you can go
directly to the EVENTS page.
Confidentiality policy - Blackweekly.com's Eight on date
members can be assured that personal information given
to us will be held completely confidential. We do not sell
our membership lists to anyone, or give out last names or
phone numbers at events.
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| First Name |
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| Last Name |
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| Mailing Address |
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| City |
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| State |
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| Zip |
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| Telephone Number |
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| Email Address |
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| Referred By? |
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| Gender |
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| Age Range |
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| Occupation |
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| Education |
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| Income Range |
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| Children? |
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| Smoke? |
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| Reson for Joining? |
Meet new people
Make new friends
Meet potential dates
Make business contacts |
| Sports/Outdoor Interests |
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Golf
Tennis
Running
Biking
Soccer
Baseball
Snow Skiing
Hiking/Camping
Travel
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Football
Basketball
Racquetball
Camping
Sailing/Boating
Swimming
Working Out
Hockey
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| Indoor/Other Interests (check all that apply) |
Reading
Writing
Cooking
Volunteering
Theatre
Dancing
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Movies
Yoga/Meditation
Ballet/Operas
Television
Computers
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| Favorite Discussion Topics (check all that apply) |
Politics
World Events
Male-Female Relationships
Education
Race Relations
Religion/Spirituality
Health
Beauty/Fashion
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| Anything else you would like to tell us about yourself? |
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| Upload your picure (headshots only) |
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ACKNOWLEDGEMENT AND WAIVER: The undersigned hereby acknowledges that Blackweekly.com's Eight on a Date is a recreation and dinner service designed for the purposes of introducing persons to each other for recreation and companionship; and Blackweekly.com Eight on a Date have not made any inquiries, investigations, or check concerning any member's or prospective members history or character, criminal or otherwise, and do not make any representations, express or implied, to the effect that there have been any such inquiries, investigations or checks made. NO RELIANCE: The undersigned does not rely on any representation, implied, or expressed, of Eight on a Date, or their employees or agents which would lead or induce the undersigned to neglect or fail to take all reasonable precautions as would be taken in like circumstances and the undersigned shall not advance any claim, cause of action or liability for any reason whatsoever on the basis of such perceived or inferred, implied or express representation.
WAIVER: The undersigned hereby expressly and voluntarily waives any and all claims, causes of action, or liability as against,Blackweekly.com's Eight on a Date or their employees or agents as a result of or arising from any actions or statement made or published by other members, facility owners, operators or employees or any other person with whom the member may have had contact or against whom a claim or cause of action may arise as a result of the membership of the undersigned with Eight on a Date.
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Acknowledgement and Agreement to Waiver and Policies
Yes,, I have read, understood, and agree with the terms of this waiver and policies and further acknowledge that by so doing, I am stopped from making any claim whatsoever against the company, its employees, agents for any cause of action.
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For more information email EightonaDate@Blackweekly.com
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