Valleyview Co-op Kids Club Membership

Valleyview Co-op Kids Club Membership

Membership application must be completed by a parent or guardian.
Parent Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Valleyview Co-op Member Number*
PO Box, Town, Province, Postal Code*
I am registering the following family members for Valleyview Co-op Kids Club
Child's first name*
Send my child a birthday card the month of (cards mailed 30th of each month)*
My child will celebrate their 12th birthday in *
Child's first name (second child)
Send my child a birthday card the month of (cards mailed 30th of each month)
My child will celebrate their 12th birthday in
Child's first name (third child)
Send my child a birthday card the month of (cards mailed 30th of each month)
My child will celebrate their 12th birthday in
If you elect to opt-in, your email address will be used to contact you regarding Co-op Kids Club membership activities. The Co-op respects your privacy and will administer the personal information that you provide to it by way of this Kids Club Application in accordance with its privacy policies and related practices. The personal information that you provide to the Co-op is being collected and may be used for one or more of the following purposes: • Address may be used to send birthday cards and other communications related to Kids Club activities. • Phone number may be used for general contact purposes related to this application or related to Kids Club activities. • Birthdate will be used to confirm eligibility for Kids Club and may be used to send birthday cards. I consent for the use of my child’s personal information to join Co-op’s Kids Club and for my child to participate in Co-op Kids Club activities.
Parent Signature

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Should be Empty:

Valleyview Co-op Kids Club Membership

I am registering the following family members for Valleyview Co-op Kids Club