Who are you?
Name of Applicant
(The actual member or participant)
Middle Name (if any):
I prefer to be called (your first name will be used if blank):
Forum Name, Handle, Callsign, Hacker Name, Secret Identity, or other nickname:
Are you a Youth Member?
This member is under 18 years of age. (Birthdate is required.)
Parent/Guardian Name (who will sign the forms)
How can we reach you?
If you get hurt, lost or kidnapped by Aliens, should we tell anyone?
What kind of membership do you need?
Full membership in Calgary Protospace Ltd ($55 per month)
Subsidized (student) membership ($35 per month)
Course or Event Registration only
Notes or special instructions
Created for Protospace by Exactical.com. ©2015-2016. It's now 22:53:08.
Bugs? Issues? Questions? Send email to firstname.lastname@example.org.