Parry Sound Nature Club

Parry Sound Nature Club

Renew or Become an Annual Member
Membership can be paid by cheque, e-transfer, or directly online at the bottom of this form. If you select the cheque or e-transfer option, an email will be sent with instructions for payment.

This membership application is accompanied by a long-term waiver, which applies as long as the member has a valid membership in the Nature Club.

Thank you for your membership!
Contact Information
Member Name *

First Name Last Name
Phone Number *
Please include area code
E-mail *
Mailing Address: *

Street Address

Street Address Line 2

City Province

Postal Code
Have you been a Nature Club Member before?

Yes No
Are you a member of Ontario Nature?

Yes No
Where did you hear about us?

Word of Mouth Online Search Nature Club Website Nature Club Facebook Page Local Activities Listing News Article Previous Member
Are there topics, species, or projects you're interested in learning about through Nature Club?
Waiver & Assumption of Liability

Please read this Waiver carefully.
*

I hereby agree to release, save harmless and indemnify the Parry Sound Nature Club, its officers, directors, agents and members from and against all claims, actions, costs and expenses in respect to death, injury, loss or damages to me or my property arising as a result of my participation in any Club events, notwithstanding that the same may have been contributed to or occasioned by the negligence of the Parry Sound Nature Club, its officers, directors, agents and members.
*

I affirm that I am in sufficiently good health that I am capable of participating in Club events, and I accept as my personal risk the consequences of such participation. In addition, I acknowledge that the risks from participation in these Club events can include, but is not limited to, bone, joint and muscular injuries, eye and facial injuries, drowning or hypothermia.
*

I agree to follow the safety instructions and other rules of the Parry Sound Nature Club. I will not participate in Club events if I am under the influence of drugs or alcohol.
*

In the event of an accident or medical problem suffered by me at a club event, I consent to Parry Sound Nature Club seeking out the appropriate medical care required.
*

I declare this Waiver and Assumption of Risk is binding on me, my heirs, executors, administrators and assigns.
*

I have read this Waiver and Assumption of Risk and I fully understand all aspects of it.
Signature of Member *

Clear
Payment Options
Is your Nature Club Membership for an Individual or Family? *

Individual ($20) Family ($40)
Name of Secondary Member

First Name Last Name
Email of Secondary Member
example@example.com
Signature of Secondary Member to Above Waiver

Clear
How would you like to pay for your annual Membership? *

Cheque by mail e-Transfer Online Credit/Debit
Payment instructions will be automatically emailed to the address provided on this form.

Online Membership Payment

Annual Individual Membership $ 20.00 CAD

Annual Family Membership $ 40.00 CAD

Optional Additional Donation $ 10.00 CAD

Optional Additional Donation $ 25.00 CAD

Optional Additional Donation $ 50.00 CAD

Total $ 0.00 CAD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Should be Empty:

Parry Sound Nature Club

Contact Information

Waiver & Assumption of Liability

Payment Options