Carstairs Community Curling Club
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REGISTRATION FORM FOR THE 2017-18 CURLING SEASON

STEP 1 OF 3: Enter registration details

Note that all required fields are marked with **


Enter Contact Details:

First Name: **
Middle Name:
Last Name: **
Gender: **
Address: **

City: **
Province/State: **
Postal/Zip Code: **
Country: **
Home Phone: **
Mobile Phone:
Work Phone:
Ext.:
Member Since: **
Years Curling Experience: **
Email:

Please enter your email address here. Email is the primary method used to communicate with our members and is only used for that purpose. If you do not have an email address please leave this field blank.

Re-enter Email:
Emergency Contact (If youth, enter parent): **
Emergency Contact Phone Number: **
Date of Birth: **
Youth members are required to enter their full date of birth including the year. If you want to take advantage of any available age discounts you must enter your full date of birth including the year.

Consent to Release Information, Privacy Policy and Anti-Spam Policy: **

I hereby consent to the use of the personal information provided above by the Club administration. Only my name and phone numbers will be listed in the membership directory and/or website for general member use. This information is intended for the sole use of Club and will not be shared outside the Club.


Injury Waiver: **

In consideration of acceptance of this registration by Club ("the club"), I HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE the club and each of its members, officers and employees FROM ANY AND ALL claims, demands, damages, costs, expenses, actions and cause of action, whether in law or equity in respect of death, injury, loss or damage to myself or property, arising or to arise by reason of my participation in the Club, that has not been contributed to or occasioned by any negligent act, by omission or commission, of any of the aforesaid.


Registration Selection: **

Select the membership type first by checking on the approproiate round checkbox. If registering for a membership type that also has league selections please check all the square checkboxes for the leagues in which you wish to play. Please show all team member names for choose your own leagues, each team member must submit their own form. Not on a team? Write assign for the other team members.

League Curling

General Membership 

Monday Ladies

Monday Sturling A

Mon Sturling B

Tuesday Mens

Wednesday Seniors (Daytime)

Thursday Mixed

Friday Night Social - Open Curling

 

Junior Membership

CCCC Junior Program

 

Little Rocks Membership

Monday afternoon Little Rocks program


Special Membership Options

Adult Non-Curling


Additional Registration Options

Locker Rental



Registration Accuracy Confirmation: **

I hereby confirm that the information I have entered on this form is correct and true. I understand that if I have intentionally entered false information in this form to receive discounts that do not apply to me there will be a $25 administration charge on top of the outstanding membership dues owed.



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