Join GHSS | Gujarati Hindu Seniors Society

I wish to become a member of the Gujarati Hindu Seniors Society, Vancouver, B.C., Canada.

Membership Application Type

Single Application1 person — $250 Life Membership Dual Application2 people — $500 Life Membership

I confirm that I am over 60 years of age. *

Applicant Information

First Name *

Last Name *

Spouse Name

Applicant Year of Birth *

Spouse Year of Birth

Address *

City *

Postal Code

Telephone *

Email *

Family Doctor

Doctor's Telephone

Next of Kin

Name

Address

Telephone

Membership Payment

Interac
e-Transfer

$250 — Single Life Membership

Payment Method: Interac e-Transfer

Send Interac e-Transfer payment to:
admin@ghss.ca

Single Application: $250 | Dual Application: $500
Your membership remains pending until reviewed and approved by GHSS.

Member's Waiver and Release Agreement

I, the undersigned for myself, my dependents, heirs, executors, administrators and assigns, hereby release, discharge and hold completely harmless the Gujarati Hindu Seniors Society, Vancouver, B.C. Canada (hereafter called the “SOCIETY”) and their respective directors, officers and volunteers (collectively called the “ORGANIZERS”), from any and all actions, claims, demands, liabilities, losses, damages or causes of action arising out of or in consequence of any loss, injury or damage to my person or property, including any expenses of any kind, resulting from my participation in or attendance at any event, activity or functions organized by the Society or its Organizers, whether arising by reason of the negligence of the Organizers or otherwise. I am also authorizing the Society to use my email and phone number to communicate with me about society activities.

I have read, understood, and agree to the GHSS Member's Waiver and Release Agreement above. *

Signatures

Applicant Signature *

Sign here using your mouse, finger or stylus.

Applicant Name (print) *

Date Signed *

Spouse Signature (if applicable)

Sign here using your mouse, finger or stylus.

Spouse Name (print)

Date Signed

DOWNLOAD PDF FORM

GHSS administration will respond within 48 hours.

GUJARATI HINDU SENIORS SOCIETY OF BC

APPLICATION FORM FOR MEMBERSHIP