Member Application

Name: Gender: Male: Female:

Address: Postal Code:

Home Phone: Business Phone: Ext:

Email:

Emergency Contact: Phone:

Age: 5-11 12-20 21-39 40-49 50-59 60+ 70+

I will not be returning this season Reason:
(Kindly return this form anyway. It will assist with membership administration)

Membership Dues (HST Incl) Check appropriate column and tally below

Active Member	$470.00	Over 21 – entitled to curl in any Day, Evening & Mixed Sections
Student	$360.00	a bona-fide full-time student has same privileges as an Active Member
New Member	$470.00	non-member of RKCC for last 3 seasons; receives a $50 pro shop voucher
Mixed Only	$333.00	entitled to curl Friday or Sunday evenings Mixed Only
Junior/Bantam**	$67/89	20 or under as of July 1, 2011 and entitled to curl in Junior Section
Little Rockers**	$67/89	11 and under
Junior member playing in adult league	$225	Minimum age is 16
Social Member	$55.00
Locker Fee	$28.00
Total

** $67 if parent/grandparent a member -- $89 if parent/grandparent non-member

PAYMENT OF DUES

Fees are payable in full by October 1, 2011. A $25.00 charge will be levied for late payment.
Payment terms are available upon request.

VOLUNTEER INTERESTS:

Bonspiels: Board (ad hoc commitees): Section events:

Curling Instruction: Learn to Curl Juniors Clinics

Canteen Services (prepping, cooking food for daily sale/serving in lounge):