Rocky Mountain Bears - Membership Form

ROCKY MOUNTAIN BEARS - CALGARY DEN
Membership (Renewal) form All club members are entered into our club database and a contact sheet is distributed to club members only. q Active Membership (April 1^{st – March 31st) $20.00 per person.} ^{q Associate Membership (50km outside of Calgary) – (April 1st – March 31st) $15.00 per person. q 1½ year Membership (available after Oct. 1st of the current year and is valid for the remainder of the current membership year and the next membership year) $30.00 (Active Membership) $25.00 (Associate Membership). Please Print Name:________________________________________________________________ Address:______________________________________________________________ City:_____________ Province/State:_____________ Postal/Zip:____________ Phone:__________________________ Date of Birth: (dd/mm/yy) ___/___/___ E-Mail Address(es):_____________________________________________________ I understand that Rocky Mountain Bears – Calgary Den is a predominantly gay male organization and certify that I am at least 18 years of age. Signature:___________________________ Date:________________________}
Do you want to be on the distributed phone list: Yes q No q May we contact you to volunteer for certain Rocky Mountain Bears events? Yes q No q Do you have an objection to your picture being on the website if taken during a Rocky Mountain Bears event? Yes q No q Do you require discretion when being contacted? Yes q No q If yes, please explain:____________________________________	*Mail your cheque/money order to:* *Rocky Mountain Bears* Box 82064 - 1400 12th Ave. S.W. Calgary, Alberta T3C 0N0 Canada Please DO NOT send cash through the mail! MEMBERS - WITHIN 50 km of Calgary - $20.00 ASSOCIATE MEMBERS - Outside 50 km of Calgary - $15.00 *All prices in Canadian Funds* Any Questions? Please contact *Rocky Mountain Bears –* Calgary Den at E-Mail: Secretary@bearbackcalgary.com