Membership Form

Use this form to register yourself as a member of our club. Please note that we must receive payment before you are added to the club list.

All fields required except where specfiied.

We value your privacy. All information obtained will only be used for our records and will not be shared or sold.


First Name:
Last Name:
Other family members:
(only required if choosing family membership)

Phone:
Street Address:
City/Town:
Postal Code:
E-mail:

Membership type: Single $40
Family $60
Junior (Under 18) $20
Senior (Over 65) $20

I found out about the York Region Parrot Club:
(eg. Internet search, Fairy Lake Festival, National Bird Shows, Other member, email to the club, All About Pets, friend, newspaper (Snap) etc. Please be as specific as possible.)

My Bird(s):
(eg. Emma/Senegal)

Comments:
(Optional. Is there anything else you want to tell us?)

Payment: Secure Online via PayPal or Credit Card
Cheque or cash (bring to next meeting)
Cheque (via Canada Post)

I agree to the following regarding bringing my bird(s) to club meetings:

To maintain the health of our flock, we ask that every bird attending any meeting sponsored by the York Region Parrot Club be checked by an avian veterinarian on a regular basis. Use caution and proper hygiene procedures when interacting with other birds. If there is any possibility that your bird is ill or may have come into contact with a sick bird, please do not bring it to the meetings. We reserve the right to refuse entry to any bird that we believe may pose a health threat to the other birds at our meetings.

I certify that, to the best of my knowledge, my bird is healthy and free of any known avian diseases. I acknowledge that the York Region Parrot Club is not responsible if my bird should become sick after attending one of the meetings. I further accept full responsibility for my bird(s) that attend any meeting sponsored by the York Region Parrot Club and acknowledge that the York Region Parrot Club is not responsible or liable for any actions or behaviours of my bird(s) while in attendance at any meeting sponsored by the York Region Parrot Club.