Membership Dependents

Membership Dependents Registration Form

Use this form to register children dependents to your membership.

Primary Member

Primary Member(Required)

First Last

Primary Member Email(Required)

Primary Member Date of Birth(Required)

Primary Member Home Phone

Primary Member Phone Work/Mobile(Required)

Secondary Member (Partner/Spouse)

Secondary Member

First Last

Secondary Member Email

Secondary Member Date of Birth(Required)

Secondary Member Phone Work/Mobile

Number of Children in Membership(Required)

Please note for more than three (3) children, there will be an additional $60.00 applied per additional child. Example: Child #4, Child #5 will each be $60 additional ($120 total).

Child Name #1(Required)

First Last

Date of Birth - Child #1(Required)

Email - Child #1

Mobile number - Child #1

Child Name #2(Required)

First Last

Date of Birth - Child #2(Required)

Email - Child #2

Mobile number - Child #2

Child Name #3(Required)

First Last

Date of Birth - Child #3(Required)

Email - Child #3

Mobile number - Child #3

Child Name #4(Required)

First Last

Date of Birth - Child #4(Required)

Email - Child #4

Mobile number - Child #4

Child Name #5(Required)

First Last

Date of Birth - Child #5(Required)

Email - Child #5

Mobile number - Child #5

Child Name #6(Required)

First Last

Date of Birth - Child #6(Required)

Email - Child #6

Mobile number - Child #6

Will you be adding a caregiver?(Required)

Family memberships include 2 adults (married or partners), 3 dependent children living in the same household under the age of 24 years and one care giver.

Yes

Name - Caregiver(Required)

First Last

Date of Birth - Caregiver(Required)

Email - Caregiver

Mobile Number - Caregiver