Play Champagne

Membership Application

Membership is required to attend events, with no exceptions.

You MUST fill out an online membership application AND be Approved PRIOR to arrival at an event. Walk-Ins not allowed.

All information submitted is strictly confidential, for internal club use only and will not be distributed to any other party.

*Important* After submitting this form, you will be sent an email with a link to confirm your email address. (Don't forget to check spam folder). After confirmation of your email, your application will be reviewed. Once it is Approved, you will receive an email with your membership number and details regarding your first visit. A membership card WILL NOT be mailed to you.

Membership Type

* = Required

Member Info

First *

Last *

Gender *
Male Female

Date Of Birth *

Second Person

First *

Last *

Gender *
Male Female

Date Of Birth *

Contact Info

City *

State *

Zip

Country

Email *

Confirm Email *

Phone

Social Sites Info Please list your profile names from any of the social sites below:

Facebook

KIK

Snapchat

SwingLifeStyle

AdultFriendFinder

SwingerZoneCentral

SwingerDateClub

Kasidie

How did you hear about our club?

Photo *

A recent photo is used for verification at check in.
If applying as a couple, ensure you are both in the photo. The photo must be a recent photo from the waist up.

Photo Upload

Acknowledgment

Read Club Terms & Conditions I acknowledge I am applying for membership to a private club and I have read the Club Terms & Conditions including the confidentiality requirements and I agree to them.