Junior Curling Membership Request

Name:

Address:

Please enter your full address: street, city, province and postal code.

Home Phone:

Business Phone:

Cell Phone:

Email:

Note: email is used to communicate and help the club keep you informed of coming events or concellations.

Which section are you looking to join?

Junior Littlerock

Age:

Birthday/Year:

Emergency Contact/Parent Guardian:

Emergency Contact Number

(If different from above)

Additional Information:

Number of years you have curled regularly:

Most recent year curled regularly:

Where did you hear about the club?:

If this application is accepted, I agree to abide by the by-laws, rules, regulations, and other resolutions passed by High Park Club, Limited ( the "Club") at all times while I am a member thereof and to pay all annual fees and assessments levied by the Club. I also consent to the Club request and obtaining a consumer report from credit reporting agency, in consideration of being accepted as a member of the club. I hereby release and hold harmless the Club and its agents, directors and officers, servants, employees, and members from any future claims whatsoever that I may have arising out of any personal injury resulting from any cause whatsoever including, but not limited to, the Club, its agents, directors and officers, servants, employees, or members' negligence. I also agree to let the High Park Club use my personal information for club use only. (The High Park Club takes the privacy of its members seriously and your information will not be shared with any other groups or organizations.)

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