25 - 26 Membership Form

1

Please list the children in your household that are registered for the Club. The following household information will only pertain to the children listed below.* This field is required.Click the green plus sign (+) to add children.

2

How many people are living in your household?

3

How many of these people are adults (18+)

4

How many of these adults are currently employed?

5

How many of these adults are in post-secondary school?

7

Please select your household income.

Less than $30,000

$30,000 - $50,000

$50,000 - $70,000

$70,000 - $90,000

$90,000 and above

8

Is anyone in the household in the military?

YESNO

9

Active Duty or Reserves?

Active Duty

Reserves

10

Parent/Guardian Name:

First Name

Last Name

11

Parent/Guardian Signature:

Clear