Application for Membership

Application for Membership, including Liability Waiver

Membership is restricted to retired or semi-retired men and women over the age of 55.
A spouse/partner (under 55) of an eligible member may also apply for membership. Both may apply at
the same time.

Effective April 1st, 2019, annual dues are $50/person for new members (includes membership badge) & $35/member for annual renewals. Membership applications completed between April 1 and May 31
will be valid until renewal on June 1 the following year.

The Application Form may be completed online, or downloaded, printed and completed. Forms and/or
cheques to be mailed to;
Glacier Probus Club,
PO Box 3592,
Courtenay, BC V9N 6Z8

When the Membership Application and payment have been processed, the new member will receive an invitation to visit the Activity Groups Directory webpage and sign up for Activity Groups.

Each person requesting membership must complete a separate Application form. If you prefer to download the application form and complete the process manually, skip this next Online Application for Membership section and continue with Manual Application for Membership.

Online Application for Membership
Remember to click the Submit button at the bottom:

* Indicates required field

Full Name, First and Last: *

First

Last

Email Address: *

Full Mailing Address: Street, City, and Postal Code *

Telephone Number: *

Volunteer and work experience *

Year of Birth *

Contact information is required in case of accident or illness when participating in a Probus Activity. In addition to your spouse's cell phone number, the number of another family member or friend is required in case both partners are affected.

Contact infromation:

Spouse Name *

First

Last

Phone Number *

Other Family Member/Friend *

First

Last

Phone Number *

Waiver of Liability: As is required in every Probus Club I agree to waive liability to Glacier Probus Club for any injury or grievance arising out of the course of club meetings, social events, or Activity Group activities held by or organized by the Glacier Probus Club or by any members of the Glacier Probus Club. This waiver also applies to any other Probus Club and its members when I participate in an Inter-club event, as well as publication
of names and photos in Club reports, videos, and websites.

Online Pay Option invoice: All online applicants will receive a Glacier Probus Club Invoice via the email address supplied.
- Invoices can be paid by mailing a cheque to the address and for the amount shown at the top of this webpage.
- Invoices can also be paid online using a credit card, debit card, or bank account (plus a small service charge).

Prospective Member Acknowlegement: *

I have read and agree with all terms and conditions shown above: Click on the Submit button below when the form has been completed.

Submit

Manual Application for Membership:

The Glacier PROBUS Club Membership Application Form can be downloaded to your computer and printed. The application form is available in either Adobe pdf format or in MicroSoft Word format. Click on the pdf version Download File to open in a new Window and print directly from there, or click on the .doc version Download File and the document will download to your computer, where you can then print it out. Be sure to print one Application for each person, attach a cheque for $50/person made out to the Glacier PROBUS Club, and sign the form under the Waiver of Liability.

2019_2020_application_for_membership.pdf
File Size:	102 kb
File Type:	pdf

Download File

2019_2020_application_for_membership.docx
File Size:	17 kb
File Type:	docx

Download File

Quick link - Application for Membership