MEMBERSHIP APPLICATION FORM

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Type of membership *

Please select one.

Full men's or women's: $470

Summer membership: $235

Schoolboy or schoolgirl: $25

Junior (under 19): $110

Young Adult: (19-25): $170

Associate: $200

Date of Birth (if Junior/Young Adult/School membership)

MM

DD

YYYY