Canadian Club Membership Form
Full Name/s: *
E.g. Mary Smith, John Smith
Your answer
Work Phone:
Please include area code and person's name e.g 09 555-5555 - John Smith
Your answer
Mobile Phone:
Please include person's name e.g. 021 777-8899 - Mary Smith
Your answer
Home Phone: *
Please include area code e.g. 09-555-5555
Your answer
Email Address (1): *
Please include person's name e.g. name@gmail.com - Mary Smith
Your answer
Email Address (2):
Please include person's name e.g. name@gmail.com - John Smith
Your answer
Membership Type
Please select one of the membership types below. We encourage everyone to please join the club as a paid member. Membership entitles you to be eligible for discounts to selected club events, supports the club’s hosting of events, enables the club to provide awesome prizes, maintain a website, and newsletters as all the support provided by the club committee for the club is purely on a volunteer basis.
Home Town/s in Canada:
Please include person's name e.g. Vancouver, British Columbia - Mary Smith
Your answer
Postal Address: *
Please include postal code e.g. 123 Any Street, Any Suburb, Any City, 1234
Your answer
Children:
Please include First Name and Age e.g. Bobby Smith - 9 years
Your answer
Submit
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