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PDF Test Kawartha Camera Club Membership Application
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This field is for validation purposes and should be left unchanged.
Date
(Required)
MM slash DD slash YYYY
Are You a Human?
(Required)
No
Maybe
Yes
Your Name
(Required)
First
Last
Your Email
(Required)
Phone
Type of Membership
(Required)
RENEWAL
NEW
Single or Family
(Required)
Single — $35
Family — $50
Receipt
Yes Please
If this is a renewal has your contact information changed from last year?
(Required)
NO
YES
Address
Street Address
City
Postal Code
Phone
Family Member (spouse, significant other, child) Name
(Required)
First
Last
Family Member Email
(Required)
Family Member Phone
Do you consent to having your contact details, including your phone number and email address shared within the membership of the Kawartha Camera Club?
(Required)
YES
NO
Questions or Comments for our Registrar about your application.
