First Name (TEST): *


Last Name: *


Birth date (mm/dd/yyyy):


Gender:
Male Female Non-binary Other Rather not say

Address: *


Apartment / Unit Number:


City: *


Province:


Postal Code: *


Home Phone:


Mobile Phone: *


E-mail: *


Your e-mail will only be used by the club to inform you of club events and activities: *
Yes, please add me to your mailing list
No, I do not wish to receive e-mail from the club
I already receive the newsletter and other information

Number of years bowled: *
New bowler Less than two years Two to five years Five to ten years Ten to twenty years More than twenty years

Member of Willowdale Lawn Bowling Club since:


Previous club (if new to Willowdale):


Fees (All bowlers to sign OLBA insurance waiver): *
Regular member $180.00 (locker included-see below) Member who has paid OLBA fees at another club $130.00 19 - 24 years of age $65.00 Junior member (18 years of age or younger) $40.00 PROBUS member $40.00 Social member $20.00

Locker information:
I would like a locker. Please e-mail me a locker number. I do not need a locker. I already have a locker.

My existing locker number:


Are you a certified coach?
No Level 1 Level 2 Level 3

Are you a certified umpire?
No Level 1 Level 2 Level 3

I have read, understood and agreed to sign one of the appropriate documents: *
The WLBC-OLBA Release of Liability, Waiver of Claims and Indemnity Agreement
The WLBC-OLBA Informed Consent and Assumption of Risk Agreement (parent / guardian)

Signature (please write your full name in ALL CAPS): *


Date: *


Emergency contact:


Emergency contact phone number:


METHOD OF PAYMENT:
I would like to pay by INTERAC electronic transfer.
I would like to pay by cheque, which I will mail to the address below.