Membership-only Registration Form

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Is the member under 18 years of age?(Required)

Yes

No

Member Information

*Youth member info to be filled out by parent or guardian

First Name(Required)

Last Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Phone(Required)

Email(Required)

Contact Information

Street Address(Required)

City(Required)

Province(Required)

Postal Code(Required)

Parent/Guardian Contact Information

Parent/Guardian #1 Name(Required)

Parent/Guardian #1 Phone(Required)

Parent/Guardian #1 Email Address(Required)

Parent/Guardian #2 Name

Parent/Guardian #2 Phone

Parent/Guardian #2 Email Address

Fees

$10 (Yearly Individual Society Membership Fee - only pay once per year)

Payment may be sent by EFT to admin@gpmusicsociety.com (please put the name of the member in the comment) by cash or by cheque made out to Grande Prairie Music Society.

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Email: president@gpmusicsociety.com

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