REGISTRATION FOR MEMBERSHIP

REGISTRATION FORM

FAMILY - $52.00

SINGLE/SENIOR/SINGLE PARENT FAMILY - $37.00

NAME:
PREFERRED TELEPHONE
EMAIL:
ADDRESS:
POSTAL CODE:
NAMES AND BIRTH YEAR OF EACH FAMILY MEMBER
1ST FAMILY MEMBER		NAME		BIRTH YEAR
2nd FAMILY MEMBER		NAME		BIRTH YEAR
3rd FAMILY MEMBER		NAME		BIRTH YEAR
4th FAMILY MEMBER		NAME		BIRTH YEAR
5th FAMILY MEMBER		NAME		BIRTH YEAR
6th FAMILY MEMBER		NAME		BIRTH YEAR
REQUIRE SKATE TAGS (Y/N)
		PLEASE ONLY PRESS SUBMIT ONCE. IT MAY A FEW SECONDS TO SEND