Join us Fill out the form below to become a part of the movement and prove you give a Damn! If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required First Name * Last Name * Company Job Title Address 1 * Address 2 City * State * Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Email * Phone Terms and Conditions I agree * I commit to making four quarterly donations of $100 to the charity chosen by the majority. - (Note that you can withdraw at anytime by contacting us. But you cannot join and then NOT participate.) I agree * If I cannot attend a meeting I will ensure my check is given to a fellow member or dropped off at the meeting, before the meeting starts (it is imperative your check reaches us before the meeting). I agree * I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote. I agree * I consent to having my information being stored in the 100 Men Who Give A Damn Dallas database. (Our database is secure. Feel free to ask us for details on our security at 100mendallas@gmail.com) Waiver The registrant (the "Releasor") hereby acknowledges: (a) that 100 Men Who Give A Damn Dallas is an unincorporated volunteer organization; and (b) alcohol may be served by third parties at meetings of 100 Men Who Give A Damn Dallas. The Releasor hereby irrevocably and unconditionally releases 100 Men Who Give A Damn Dallas, its organizers and volunteers (collectively, the "Releasees") , from and against any suits or actions, any claims or demands whatsoever which may be brought by the Releasor for damages resulting from the actions and/or negligence of the Releasees whether under the provisions of any statute, common law, equity or contract. I have read the above release and waiver of liability and fully understand its contents and I voluntarily agree to the terms and conditions stated above. I agree to the Terms and Conditions and Waiver *