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January 3, 2026
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Type of Membership
RENEWAL
SINGLE – $35
RECEIPT REQUESTED
NEW
FAMILY – $50
If this is a renewal, has your contact information changed since last year?
YES
NO
Primary Member Name
*
First
Last
Street Address
City / Postal Code
Phone Number
Email
*
Comments child) Number
Secondary Member (signiicant other, spouse, child) Name
Phone Number
Email
Do you consent to having your contact details, including your phone number and email address shared within the membership of the Kawartha Camera Club?
*
Yes
No
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