Membership Request Form

Complete this form and mail it with your cheque to :

Memberships c/o
Jacqui Krahn
11235 58 Ave.
Edm, Ab
T6H 1C3

                                                             Name :________________________
                                                 Address:______________________
                                                                         _____________
                                                 Postal code :_________
                                                 Phone :_____________

                                 Membership type: please check (price is per houshold)
                                        c Family or Single $25.00  c  Senior $10.00
                                        c Yes I would like more information about Volunteering
                                        c Yes I would like more information about programs
                                       __ Number of skate tags required