Parry Sound Nature Club

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!

Name*

First NameLast Name

Phone Number*

Please include area code

E-mail*

Mailing Address:*

Street Address

Street Address Line 2

CityProvince

Postal Code

Have you been a Nature Club Member before?

YesNo

Are you a member of Ontario Nature?

YesNo

Where did you hear about us?

Are there topics, species, or projects you're interested in learning about through Nature Club?

*

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*

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

Individual ($25)Family ($50)

Name of Secondary Member

First NameLast Name

Email of Secondary Member

example@example.com

Signature of Secondary Member to Above Waiver

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

Cheque by maile-TransferOnline Credit/Debit

Payment instructions will be automatically emailed to the address provided on this form.

Online Membership Payment

Annual Individual Membership $25.00CAD

Annual Family Membership $50.00CAD

Optional Additional Donation $5.00CAD

Optional Additional Donation $10.00CAD

Optional Additional Donation$15.00CAD

Total $0.00CAD

Credit Card

How would you like to be reminded to renew your annual Parry Sound Nature Club membership?

Email noticePhone callCalendar InvitationOther

Parry Sound Nature Club

Contact Information

Waiver & Assumption of Liability

Payment Options

Credit Card