2018 Member Registration & Commitment Form

If you want to be part of a powerful group of local women making an immediate and positive effect in our community and want 100% of your donations to go directly to a chosen charity, then please join us. Become a registered member of 100 Women Who Care Regina today!

I would like to sign up as a: *
Contact Person Information
If you are signing up as a company or group you must have a contact person. Please put their information below. If you are signing up as an individual complete the below as well.
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
By submitting this registration form, and checking the boxes below, I, (Type Full Name) am committed to being a member of 100WWC Regina for a minimum one calendar year (four consecutive quarterly meetings.) *
Your answer
I am making a commitment to 100 Women Who Care Regina to make an annual donation total of $400 ($100 at each of four meetings) which will be given directly to the majority selected at each of the FOUR meetings a membership year local charity serving Regina and surrounding area. *
Required
I agree that I will provide my $100 donation at each meeting (via cheque, cash or ETransfer)or online if that is an option forthe chosen charity in order to receive a ballot to vote, even when I am not able to attend a quarterly meeting. *
Required
I will clearly communicate with 100WWCR committee when I am unable to attend or pay my donation PRIOR to the meeting. *
Required
I consent to my information being stored in the 100 Women Who Care Regina database. I understand that they will not share, sell or misuse this information and any charity chosen also agrees to not contact me in the future except to issue the official tax receipt if applicable. *
Required
I understand that my image may appear in photos and/or other media taken at our meetings which may appear on the website, print media as well as social media pages of both 100 Women Who Care Regina as well as other 100 Women Who Care Chapters and members of 100 Women Who Care social media feeds. We encourage our members to spread our news on their personal social media feeds. *
Required
I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote
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