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Protospace Membership Application
First Name
Last Name
Preferred Name (Optional)
Mailing Address
City, Province
Postal Code
Email Address
Phone Number
How did you hear about Protospace?
Emergency Contact Name (Optional)
Emergency Contact Phone (Optional)
Students - Institution Name and Course of Study (Optional)
I confirm that the information I have provided is true and correct. I promise to be excellent to people.
I am aware of, and will abide by, the member responsibilities listed in the Bylaws of Calgary Protospace, Ltd. I have signed
or will sign a "Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement". I release Calgary
Protospace Limited, its members, directors, staff and agents from any and all liability arising out of this application, my use
of equipment, tools or space at Protospace and my participation in any Protospace program, facility or event.
I agree to pay the required dues for membership. I understand that failure to do this may result in termination of my
membership. I understand that dues will continue to be charged unless I request to end my membership.
I am also aware that my application is subject to review and a probationary period before my membership becomes active.
Signature of Applicant or the Applicant's Parent or Guardian
Date (YYYY-MM-DD)
Notes or Comments
Payment of your first dues is required with this application.
Payment Amount
Payment Date
Receipt Number (for cheque or cash)
Where will we find your payment?
I made a one time payment via PayPal or email Interact
I set up a recurring PayPal payment
I paid by cheque
I paid by cash
I paid by a credit card (Square)
Sponsors and Approval
Sponsor 1 - Name
Signature
Date Signed
Sponsor 2 - Name
Signature
Date Signed
ID checked by:
Application checked by:
Liability form checked by:
Confirmed by Director:
Signature
Date Signed
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Please keep in the welcome room desk, then file in the black cabinet upstairs upon vetting or membership expiry.
Paid Sponsored & Approved Vetted Got Card