Ye Loyal Krewe of Samuel Bellamy Membership Application

Full Name:
Date of Birth:
Street Address:
City, State and Zip::
Phone Number:
Cell Number:
Fax:
Email:
Employment/Position:
Choose Parade (Please Note Surcharge):
Referral Name (if any):
Questions or Comments:

I hereby apply for an apprentice membership to
Ye Loyal Krewe of Samuel Bellamy
and by submitting this form, I certify that:

I am over 21 years of age, I am solely responsible for my actions during
any Krewe function, and will not hold the Krewe responsible for any
reason for harm to my person or possessions.
If accepted, I will abide by the Bylaws and to work for the betterment
of the organization at all times.

Please submit your online apprentice membership application above.

Click Here to Download Mandatory Waiver

Upon receipt, we will contact you and request you to mail the mandatory waiver above with the $35.00 apprentice membership fee and parade surcharge (if applicable) made payable to the name and address below:

Ye Loyal Krewe of Samuel Bellamy
P.O. Box 2130
Brandon, FL 33509