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Client Profile and Agreement

 

First name:
Last Name:
Email:
Confirm Email:
Password:
Confirm Password:
Contact Phone:
Cell Phone:
Address:
City:
State:
Zip:
Country:
Gender :
Age :
Birthday Month:
Day: Year:
Occupation:
Education:
Nationality:
Height:
Weight:
Hair Color:
Eyes Color:
Skin color:
How many children
do you have ?:
How many living with you ?:
Have you considered
children in the future ?:
I'm looking for:

Do you have a US Passport ?:

Legal Status in the USA:
Do you smoke ?:
Do you drink alcohol ?:
Do you use drugs ?:
Do you have a criminal record ? :
If so, what have you been arrested
for and/or convicted of :
Religion:
Comments:

Character & Personality:

Check all that apply
patient positive funny comprehensive adventuresome
calm energetic extrovert trustworthy humorous
amorous honorable faithful organized demanding
romantic serious introverted self esteem powerful
intelligent loyal giving gentle kind
tender home-loving neat generous sexy
prudent responsible supportive decisive honest
sensual active creative happy ambitious
sociable Other (s)

Entertainment & Hobbies:

Check all that apply
football baseball dining out painting walking
listening the music golf reading travel hiking
enjoy friends dancing exercising cycling enjoy children
movies softball camping art I enjoy animals
basketball swimming shopping singing play an instrument
volleyball working photography skating enjoy the river
theater hobbies boating the beach
Other (s) I enjoy collecting:

My Ideal soulmate

What are you looking for in a mate?
What is your dating age range? to
Do you want a formal Relationship (Matrimony)
/ informal (Just Dating):
Would you date a person with children ?
I'm interested in more membership info of the:
How did you hear about us:
I was referred by:
Upload your picture here:
Picture 2 (optional):
Picture 3 (optional):
Picture 4 (optional):

 

I AUTHORIZE YOUR NEW DESTINATION (YND), IT’S OWNER (S), OFFICERS, EMPLOYEES, STAFF, AGENTS, OR ASSIGNS, TO USE MY PHOTOS AND VIDEOS AND PROFILE INFORMATION FOR ANY PURPOSES RELATED TO ANY EVENT OR MY MEMBERSHIP IN YND.I HEREBY WAIVE FOREVER ANY AND ALL CLAIMS AGAINST YND FOR THE USE OF SAID PHOTOS AND VIDEOS.
I AGREE I HAVE READ, UNDERSTAND THE COMPANY AGREEMENT, DISCLAIMER, CODES OF CONDUCT, AND PRIVACY POLICY AND ALL OF IT'S PROVISIONS CONTAINED WITHIN.

                                      *Important please read the Agreement, Disclaimer, Code of Conduct and Privacy Policy. The link is under Contact Us menu.