2026 GLCR Membership Form
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Email *
Membership Type:

Affiliate Membership - $5
• Regular updates on events
• Access to the club from January - December 

 General Memberships - $40
• Regular updates on events
• Access to the club from January - December 
• Membership appreciation events
• Voting Rights
• Volunteer Opportunities

Please carefully read the waiver provided. By signing this document, you acknowledge and agree to the terms and conditions outlined within. If you have any questions or concerns, please seek clarification from one of our volunteers before clicking "I agree". *
First name *
Last name *
Address: Street/Box # *
Address: City *
Address: Province *
Address: Postal code *
Phone number(s) *
Email: *
I grant the GLCR - Q Nightclub & Lounge permission to send me regular updates by email.

By selecting 'No,' you acknowledge and understand that you will not receive a digital 2025 membership via email.
*
Required
I am willing to volunteer (only applicable for General Memberships)
Clear selection
What skills/profession do you possess that could assist your community with projects? (Ex: plumbing, electrical, general maintenance, event planning, accounting, IT services)
I hereby submit this application for a membership to the Gay and Lesbian Community of Regina. 

I acknowledge that I will respect the rules, regulations, and the code of conduct of the Gay and Lesbian Community of Regina. I also will respect the privacy and confidentiality of all patrons of the Gay and Lesbian Community of Regina within or outside of the community centre. I also confirm the above information is correct. 
By typing my name I hereby understand that it will act as my signature consenting to the above information *
Date *
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Almost Finished!
Please present your phone and photo ID to the volunteer for verification of your information and to complete the payment process. The volunteer will assist in confirming your details, ensuring accuracy, and will record their name to verify your information before processing your payment smoothly and securely. Thank you for your cooperation!  

PLEASE DO NOT SUBMIT THIS FORM BEFORE PRESENTING YOUR PHONE TO OUR VOLUNTEER TO VERIFY YOUR INFORMATION. IF WE DO NOT SEE ONE OF OUR CURRENT VOLUNTEERS VERIFYING YOUR INFORMATION YOUR DETAILS MAY BE DELETED.
Volunteer Name:

PLEASE PRESENT YOUR PHONE TO THE VOLUNTEER TO VERIFY INFORMATION. OUR VOLUNTEER WILL PLACE THEIR NAME IN THE FIELD BELOW. 
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