FOM ANNUAL MEMBERSHIP FORM
Enroll in FOM Music Society to enjoy access to all of our programs!  Remember to renew your membership annually, from the date you first signed up.
The information you provide will be kept confidential
2328 Trent Street, Victoria, BC V8R 4Z3 (250) 592-5114 Email: info@friendsofmusic.ca
Up-to-date information, newsletters and calendars are available online at www.friendsofmusic.ca
FOM Music Society (a.k.a 'Friends of Music') is a Registered Charity # 13285 5735 RR0001
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Full Name *
Your Pronouns  *
Street Address *
City *
Province *
Postcode *
Phone (Landline)
Phone (cell)
Email address
Which groups are you interested in joining? See website for times and descriptions. ALL our groups comply with the health and safety guidelines set by Island Health.  For OPEN MIC, use our Facebook Group, if you can’t attend in person.
WOULD YOU LIKE THE NEWSLETTER/CALENDAR EMAILED TO YOU 6 times per year?
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EMERGENCY CONTACT INFO: (name and phone number)
Any medical information you wish to share with us
If you ticked YES to Moodswing Orchestra, Haywires Country Band, Minds at Work (R & B) or Recovery Rock Band, please name which instrument/s you would like to play
Would you like to volunteer with Friends of Music Society?
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What skills are you most interested in sharing?
When are you available to volunteer?
MEMBERSHIP - Is this a renewal or a new membership?
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Please select the membership type:  
*Please note: Membership is not a condition of participation, and if you are facing financial barriers, our programs can be accessed at no cost. Just choose the 'opt-out of paid membership' option.
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I HAVE PAID MY MEMBERSHIP FEES VIA: *
Would you like to make an additional donation? (OPTIONAL - this is separate from membership fees)
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DONATION AMOUNT:  (if none, write N/A)

Please check below that you have read and agree to FOM Music Society’s Membership Guidelines

I understand that breaking of these guidelines will result in consequences up to and including being asked to leave the premises and/or the program.

PHOTO / VIDEO RELEASE (optional)  I hereby authorize FOM Music Society (Friends of Music) and those acting on their behalf to: 1. record my likeness, voice or music playing on a video, audio, photographic, digital, electronic or any other media, 2. use my name and biographical information in connection with such recordings, and 3. use such recordings in any medium (examples, website, social media, posters, newsletter) for promotional, educational and other lawful purposes. I release and waive any claims or rights of compensation or ownership regarding such uses and understand that all such recordings shall remain the property of FOM Music Society. I certify that I am 19 years of age or older or that a parent / guardian has signed below.
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How did you hear about us? *
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