JUNIOR APPLICATION

(Under 18)

Rulebook

First Name

Last Name

Date of Birth

Home Address

City

Province

Postal Code

Home Phone

Celluar Phone

Junior’s Email Address

Parent’s Email Address

Parent 1

Emergency Contact Number

Parent 2

Emergency Contact Number

GUARANTEE

I hereby guarantee payment to the Club of all fees, dues, accounts and indebtness of:

First Name of Junior Applicant

Last Name of Junior Applicant

Name of Parent Member:

Parent Member Account Number:

Signature of Parent Member

I agree the information provided is accurate as per my knowledge.

I have read the Membership fee information.

I have read the rulebook.

Date : 2024/05/05