Membership Registration NEW & RENEWAL MEMBERS Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *EmailConfirm EmailPhone *Gender *MaleFemaleBirth Date (mm/dd/yyyy) *Address *Address Line 1Address Line 2City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvincePostal CodeHearing Level *DeafHard of HearingHearingFirst Nations *YesNoDo you have NCCP or Coach Certification?YesNoWhich level for which sport?Sport(s) of Interest *Are you a member of affiliated Association/Club? *BC Rockies - Deaf Ice HockeyBC Deaf Disc Golf ClubDeaf BC GolfDeaf Games BCGreater Vancouver Deaf Curling ClubGreater Vancouver Deaf Bowling ClubOkanagan Valley Association of the DeafSouth Vancouver Island Association of the DeafNone of the aboveMembership Level *Student (youth - age 18 and under)Student (adult - age 19 and up)AdultWhich school do you go to? *I am renewing my membership before December 31st.NoYesWould you like hard-copy newsletters and flyers mailed to you? *YesNoI would like to make a charitable donationOr donate online by credit card through www.canadahelps.org.Would you like a tax receipt?(Only applicable if you're donating over $20.00)YesNoMedia Release (Photograph & Video Recording) *I understand that photographs, and/or video recordings may be used by the BC Deaf Sports Federation in its general publicity, social media, informational brochures and newsletters, and future promotion for sport activities. Consent may be withdrawn at anytime upon written notice to the BCDSF office. If you have any questions, please email info@bcdeafsports.bc.ca.I agree and give permission for the BC Deaf Sports Federation to take photographs and/or video recordings of me (or my child).I do not agree and do not give permission for the BC Deaf Sports Federation to use photographs and/or video recordings of me (or my child).Parent or Guardian's Contact InformationAre you registering on behalf of a member who is age 15 and under?YesNoPlease fill out below with your name, phone number and email address where we can reach you.Parent or Guardian's Name *FirstLastParent or Guardian's Email *Parent or Guardian's Phone *PaymentStudent under 18Price: $ 0.00Student under 18 - RenewalPrice: $ 0.00Student over 18Price: $ 10.00Student over 18 - RenewalPrice: $ 5.00Affiliated Member (Student under 18)Price: $ 0.00Affiliated Member (Student under 18) - RenewalPrice: $ 0.00Affiliated Member (Student over 18)Price: $ 5.00Affiliated Member (Student over 18) - RenewalPrice: $ 0.00AdultPrice: $ 20.00Adult - RenewalPrice: $ 15.00Affiliated Member (Adult)Price: $ 15.00Affiliated Member (Adult) - RenewalPrice: $ 10.00NewsletterPrice: $ 10.00Total$ 0.00Credit Card (skip this step if total value is $0.00)If you prefer to pay by e-transfer, please submit this form and e-transfer the owing amount to info@bcdeafsports.bc.ca.CardName on CardSubmit
