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Club NameName of MemberMembership Type
(Please use the dropdown menu)
Membership Fee (Please use the dropdown menu) Role (Please use the dropdown menu) DOB mm/dd/yyyyCompetition Age 2021/2022 Season (Please use the dropdown menu) Competition Gender (Please use the dropdown menu) Email address
*Each athlete under the age of 18 must supply the email address of a guardian aged 18 or older for the purposes of communication and voting*
Name of Guardian
(if under the age of 18)
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IndependentDeirdre DeGagneFull$50Volunteerdcdegagne@gmail.com
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