Regular Memberships - Auto-Renew Form

Primary Cardholder Information

Title: *

If other:

First name: *

Last name: *

Address: *

City: *

Province: *

Postal Code: *

Telephone: *

Email: *

For Dual and Family Memberships. If none indicated, a Member+Guest card will automatically be issued.

Title:

If other:

First name:

Last name:

Email:

I would like to receive emails about upcoming member events and programming

Yes

No

(If Applicable)

From:

Additional Notes:

Press submit to proceed to payment page

1723 Hollis Street, Halifax, Nova Scotia B3J 1V9

Call 902 424 5280

341 Main Street, Yarmouth, Nova Scotia B5A 1E7

Call 902 749 2248

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