AGOAC Membership Application Form

1) Please fill out all necessary fields and click the [SUBMIT] button to print out this form, then...
2) Bring the printed form along with your ID (for proof of age & residence) to apply in person.
Name:
Address:
Email:
Home Phone:
Cell Phone:
Date of Birth:   Gender:   Female   Male
Spouse's Info:
Must provide if under 55
Emergency Info:
MEMBERSHIP TERMS
• Membership is available to City of Markham residents or taxpayers only (Proof of residence must be shown).
• Membership is available to non-residents of City of Markham subject to Club membership restrictions.
• Applicant must be at least 55 years of age (except spouse of member).
• Membership fees are not refundable and not pro-ratable.
• Membership fees must be paid in full annually (no partial payment).
• Membership must be obtained in person only.
• To adhere to and comply with the Code of Conduct and Operating Guidelines for Seniors Clubs in the City of
   Markham, and to the Club constitution and bylaws.

MEMBERSHIP PRIVILEGES
• To attend and participate in on-going programs and special events (additional costs may apply)
• To attend annual general meetings and participate in the election process.
• To bring matters related to the operation of the club to the attention of the Board of Directors
• Failure to comply with the above may resultin privileges and/or club membership being revoked.

ACKNOWLEDGEMENT
I have read the terms of membership and membership privileges, and agree to release, discharge, indemnify and save harmless the club from and against all claims and proceedings in respect of any costs, losses, damages, or injury. By joining, I agree to any necessary medical attention that may arise and accept inherent risks associated with the program.