Membership Application


The Individual VIP Membership includes free Tuesday education, free workshops, and special invitation to the BR volunteer party. Other benefits may be added later.

By completing and submitting this form I am agreeing to the following: I am at least 18 years of age and I am not acting in the capacity of or in association with any law enforcement, media, or religious organization. By my signature here, I hereby assume all risks incidental to my attendance at Black Rose events. I agree to abide by all Black Rose Policies and Procedures and to obey all published Event Rules. I agree to hold harmless Black Rose, Inc., its Board of Directors and Officers, and their agents, assigns and successors, and the owners, managers, employees and agents of any facility in which Black Rose hosts an event for any injury to person or property which may occur incident to my attendance at a Black Rose event. I swear/affirm that I am not a registered sex offender in any jurisdiction. Any falsification of this form or of the signatures will result in termination of membership with no refunds. Memberships are not transferable or refundable.


Black Rose, Inc. P.O. Box 101222 Arlington, VA 22210-4222 USA • (202) 656-0762 • Privacy Policy

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