Whitby Curling Club

MEMBERSHIP APPLICATION

Whitby Curling Club
815 Brock St. North
Whitby, Ontario
L1N 4J3
Phone: (905) 668-5021
Fax: (905) 665-0770
whitbycc@sympatico.ca

*NOTE: THIS APPLICATION IS FOR NEW MEMBERS ONLY. RETURNING MEMBERS PLEASE CONTACT THE CLUB IF YOU HAVE NOT YET RECEIVED YOU PACKAGE IN THE MAIL.

NAME:	ADDRESS:	HOME PHONE:		WORK PHONE:
		( ) -		( ) -
EMail Address:				Postal Code -
All fees include O.C.A., Capital Fund, Parking Lot, and G.S.T.		Rate Per Person		Total
Adult (30 to 59 years old):			$370.00	$
Adult (20 to 29 years old):			$300.00	$
Senior (60 and over):			$300.00	$
Junior (16 to 19 years old):			$200.00	$
Social:			$100.00	$
Prize Money:		Rate Per Person		Total
Ladies Afternoon Curling:			$20.00	$
Business Womens Evening Curling:			$20.00	$
Ladies Sunday Evening Curling:			$20.00	$
Senior Mens Morning Curling:			$20.00	$
Mens Evening Curling:			$20.00	$
Mixed Evening Curling - Wed or Fri:			$20.00	$
Mixed - Fixed Time - Fridays 4:30 only:			$20.00	$
LOCKER RENTAL			$15.00	$
		TOTAL FEE:		$

We accept the following methods of payment : Cash, Cheque, Debit, Visa, Mastercard, or American Express