Membership Application

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Date of Birth:

Marital Status:

Living Accomodations:

Transportation to Centre:

In case of illness or an emergency notify:

Date:

“This Membership Application will be kept in strict confidence.”

Membership renewal is due annually September 1st.

PLEASE READ THE FOLLOWING:

Transcona Retired Citizens Org Inc does not accept any responsibility for any claims, demands, damage, actions or causes of actions arising out of, or in consequence of any loss, injury or damage to any person incurred while attending at, or participating in activities, organized, sponsored or carried out by Transcona Retired Citizens Org Inc. In particular, all physical activities are, “at risk of the participant”. I have read and understand this disclaimer and give consent to the gathering of the above information for the purposes previously mentioned.