Membership Form for Screen Reader Membership TypeThis Section for Membership Type - 2 questionsAre you a new member or renewing member? I am a New MemberI am a Renewing MemberWhat is the Sight Class The sight class is BlindThe sight class is Partially SightedThe sight class is Deaf/BlindThe sight class is Sighted Membership Form - personal informationThis Section is to collect personal information - 11 questionsLast Name *First Name *Street Address City/Town Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundlandNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonPostal Code Telephone (Cell) (Format: xxx-xxx-xxxx) *Telephone (Other) (Format: xxx-xxx-xxxx) Email *What is your Age Category Age category is 0-4Age category is 5-12Age category is 13-17Age category is 18-54Age category is 55+What is your Gender Gender is MaleGender is FemaleGender is Other CNIB Number and Coaching InformationThis Section for CNIB number and Coaching Information - 2 questionsEnter CNIB Registration Number if applicable If you are a coach, enter NCCP number Emergency Contact InformationThis Section collects emergency contact information - 3 questionsName *Relationship *Phone (Format: xxx-xxx-xxxx) * SportsThis Section collects information on what sports you are interested in - 2 questionsSports of Interest AthleticsActive Living Network for AdultsCurlingDragon BoatDragon Boat Dryland -VirtualFitness - VirtualGoalballGolfHockeyJudoLawn BowlsPowerliftingShowdownSwimmingTandem CyclingTennisWalkingWrestlingYoga - Chair - VirtualOtherOther Sports Payment InformationThis Section collects payment method - 1 questionPayment Method *Membership Fee 15$Credit CardeTransferCheque CommunicationThis Section collects your communication preference - 1 questionPreferred Communication Format EmailPrintNotes Membership in BC Blind Sports and Recreation Association may include membership in the Canadian Blind Sports Association. Anti-SpamPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
