___ Mr.        ___ Mrs.       ___ Ms.      ___ Miss

Name: ___________________________________

Home Address: ________________________________________________________________

City: _______________________ Province: ______________ Postal Code: ______________

Home Phone: ______ - _______ - __________  Business Phone: ______ - ______ -__________

Fax: ______ - ______ - __________ Email: ________________________________________

Preferred Method of Communication: ____________________________

Credit Card Information: We require a credit card on file for member signing privileges.

Card:_________________________________ expiry:______________________

Preference of Accrued Account (Please check) � Billed Monthly to Card    � Invoiced and Mailed

*Please complete the following if more than one active player per membership

Spouse Information

___ Mr.       ___ Mrs.      ____ Ms.      ___ Miss

Name: ____________________________________

Business Phone: ______ - ______ - _____________ Email: _____________________________

Dependant Information

Name(s)                                                     Date of Birth                      M/F

___________________________     _____________________       _____

___________________________     _____________________       _____

___________________________     _____________________       _____