Join Us! Join Us! Join Us! Name * First Name Last Name Email * Number * (###) ### #### Address * Emergency Contact Information Optional Name Number (###) ### #### Relationship Interest and Needs Optional Art Interest Painting Drawing Sculpture Ceramics Printmaking Photography and Video Mixed Media I'm Not Sure Yet Other... Equipment or Supply Needs Do you have any needs for disability services? If so, please describe: Do you have any language needs? If so, please describe: Membership Terms and Conditions Membership at The Underground: A Center for Creative Collaboration is free. Membership may be revoked for infractions on our Community Agreement or through written notice and reason by the Staff and/or Board of Directors of The Bridge Progressive Arts Initiative. To validate your membership, upon arrival you must sign: 1. Community Agreement (https://www.thebridgepai.org/community-agreement) 2. Safety and Liability Waiver (https://www.thebridgepai.org/safety-and-liability-waiver) The terms of free membership are always dependent on donations and funding for the initiative, but all members will be notified and given the option, by written consent, to opt in to any paid membership program in the future. While we do not anticipate this happening, we want to be transparent in the event that it does. I have read the terms of this agreement and understand my membership will not become active until I have signed a Community Agreement and Safety and Liability Waiver * Yes Check-Out Requirements (NOT REQUIRED) Please note that in order to check out any equipment or materials from The Underground, a valid ID must be on file with our staff. If you are uncomfortable submitting this information through this form please bring your ID when you come to The Underground in person. Name First Name Last Name ID Type ID Number Expiration Date MM DD YYYY Would you like to become a Donor Member during your orientation? Yes No Would you like to make a one-time donation during your orientation? Yes No Demographic Information (NOT REQUIRED) Lastly, we would appreciate it if you could provide us with optional demographic information that will help us better understand and serve our community. Please note that this information will be used only internally as part of reporting to grantors and funders about the communities we serve. All personal information such as name, address, phone number, email, and ID will not be used in such reporting, and only the information within this section will be shared. Age Gender Occupation Do you identify as an artist or creative person? Yes No Are you a member of a historically marginalized community (e.g. BIPOC, immigrant, refugee, low-income, etc.)? Thank you!