Loading...

Brothers of the Leaf Inc is a private membership organization under the management of the Brothers of the Leaf Inc board of directors. The board of directors reserves the right to deny membership if the minimum qualifications are not met or if the board votes that the applying person is not fit for membership. The board of directors adopts the rules and regulations that each member must abide by. Violations of the rules and regulations may lead to suspension or revocation of your membership.

1. You must be active or retired law enforcement, firefighter, EMS, dispatch, military (including prior service but not retired), corrections, a family member, or friend of someone in one of these categories to qualify for membership. Please contact Frank or Devyn if you are not sure if you qualify.

2. Your keypad code to enter the club is unique to you. For the security of the club please do not share your keypad code with anyone.

3. Each member may invite an unlimited amount of guests to the club per month. Please avoid bringing the same guest more than once per month. Your spouse, girlfriend, boyfriend, etc does not count as a guest and they may accompany you unlimited times. If you are looking to bring more than 4 guests on any given day please give us a call. It typically will not be an issue, we just like to be prepared. You must accompany your guests at all times. Non-member guests may not access the club without you present. The board of directors reserves the right to decline guests who attempt to circumvent the rules. 

4. We have a fully stocked humidor but you may bring your own cigars if you like. There is no cutting fee. Alcohol must be purchased from the club and served by the bartender. 

5. No cigarettes, vape clouds, hookahs, or marijuana inside the club. Cigars, pipes, or E-cigarettes only please. 

6. The bartender on duty has full authority to make decisions that are in the best interest for the safety of you and other members. This includes but is not limited to denying entry, denying to serve alcoholic beverages, asking other members for assistance, etc. 

7. Irresponsible, disrespectful, and/or dangerous behavior may lead to suspension or revocation of your membership. 

*YOU WILL NOT BE ASKED FOR CREDIT CARD INFORMATION ON THIS FORM. PLEASE CALL US AT 845-306-4558 AFTER YOUR FINISH THIS APPLICATION TO COMPLETE YOUR MEMBERSHIP. None of your information will be shared or sold for marketing/promotional purposes. Brothers of the Leaf is the only organization your information will be used for. 

First Members Name

First Name*

Last Name*

Phone*
First Members Date of Birth*
First Members Signature*
Second Members Name

First Name*

Last Name*
Second Members Date of Birth*
Third Members Name

First Name*

Last Name*
Third Members Date of Birth*
Fourth Members Name

First Name*

Last Name*
Fourth Members Date of Birth*
Fifth Members Name

First Name*

Last Name*
Fifth Members Date of Birth*
Sixth Members Name

First Name*

Last Name*
Sixth Members Date of Birth*
Seventh Members Name

First Name*

Last Name*
Seventh Members Date of Birth*
Eighth Members Name

First Name*

Last Name*
Eighth Members Date of Birth*
Ninth Members Name

First Name*

Last Name*
Ninth Members Date of Birth*
Tenth Members Name

First Name*

Last Name*
Tenth Members Date of Birth*
Parent or Guardian's Email Address

Email
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Membership Qualification
Please check the box for your membership qualification. *
Active or retired law enforcement, corrections, firefighter, EMS, dispatcher, or military (including formerly enlisted).
Family member or friend of active or retired law enforcement, firefighter, EMS, dispatcher, or military.

What department or branch do you or did you work for?

What department or organization did your family member or friend work for? Please include their first and last name.
Membership Selection
Which membership would you like? *
Monthly recurring credit card ($43.50)
Annual recurring credit card ($500.00)
Annual cash or check ($500.00)
Annual Venmo or Zelle ($500.00)
Locker Selection
If you would like a cigar locker choose your payment method. You may share a locker with friends who are members. Lockers are not humidified. Please store your cigars in a box or bag with a Boveda pack. You may store a bottle in your locker. Your personal bottle may be consumed at times the bartender is not on duty. There are glasses for your use in the kitchen cabinet. You may use ice from the ice machine in the kitchen. When the bartender is on duty and you wish to drink from your bottle, the bottle you wish to consume must be a bottle that we do not already carry, the bottle must be served by the bartender, and there is a $5 per 3oz pour fee.
Annual recurring credit card ($250.00)
Annual locker cash or check ($250.00)
Annual locker Venmo or Zelle ($250.00)
Members Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!