Accel-a-Date for Dayton-area Singles

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For a limited time, membership in Accel-a-Date is FREE! Just take a couple minutes to fill out our Membership Survey. It's your key to quick registration for future events, and invitations to special events based on your personal interests and preferences. There's no obligation, so sign up now!

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Use this form for check pre-payment. On-site registration cost for most events will be higher.
For priority confirmation, pre-pay securely by credit card by clicking here

Event(s):

February 2 - Singles with a Heart!
Give Blood For Love, sponsored by Accel-a-Date, Chick-Fil-A, and Community Blood Center
Ages 21+ - FREE Event - More Info

February 19 - Speed Dating Ages 34-49
- $25 advance, $30 at door - Java St. Cafe

Member Name:

E-mail:
IMPORTANT: Please enter carefully in format name@host.com

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Gender/Age: Female Male
Year of Birth: (example: 1963)

Accel-a-Date
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Evening Phone:

Mailing Address:

Smoker: Yes Sometimes No

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Comments:

How did you
find us?: Friend Radio Web Link/Search
Ad/Flyer At a singles event
Newspaper article Other

Important: By submitting your registration, you indicate that you have read and comply with our Policies and Disclaimer and that you agree to pay the event fee. Cancellations must be made at least 48 hours prior to the event.

Information provided is only used for your registration and to notify you about upcoming events of interest. For details, please refer to our Privacy Policy.

Confirmation priority will be given to pre-paid registrations. You may pay at the event, but you can help ensure your spot is reserved by submitting your payment in advance. You will receive instructions for mailing payment the business day after you submit your registration. You may also send credit card payment securely via Paypal.

Payments are not refundable, except for refunds due to overbooking or rescheduling of an event by Accel-a-Date. Reservations may be changed to another event up until 48 hours prior to the original event at no additional charge, or you may choose to receive an Accel-a-Date gift certificate by mail. Late cancellations or "no-shows" will not be refunded.

Same gender/age range substitutions are permitted up until the time of the event at no additional charge, subject to our policies and disclaimer.

This policy is to help ensure a sufficient number of participants at each event so that everyone can meet plenty of new people! (Amended 6/11/03)

No e-mail? Phone us at (937) 859-6200
Accel-a-Date • P.O. Box 750513 • Dayton OH 45475-0513