Annual Registration Form

If you do not have a printer, please ask for a copy of this form by clicking here.
Select One :	New Membership Renewal of Membership
Name :
Names of all members at this address :
	Renewing Members please fill in any changes only:
Cottage Phone Number :
Cottage Green Sign # :
Road Name/ Address :
Home Mailing Address :
Home Phone # :
Cel Phone# :
EMail :
Fax :

Annual Membership Fee is $25.00

(Annual fees are used to asist with FOCA membership, publishing the newsletter, developing and maintining the website, funding the social events, educational materials and workshops.)

Would you be interested in :
Yes No	Helping as a Committee Member. We meet once a year in May for 2 hours, and again for 2 hours with lake members, usually in July. Other communications are done via email, telephone, or mail.
Yes No	Planning or hosting Socials, BBQs, Dock times.
Yes No	Helping with the Newsletter or Web Site with photos, links, stories, township news, history, environmental issues, etc.
Yes No	Helping with Environmental/Land/Water/Air Issues, to keep lake members informed of current affairs. MNR Activities especially if it affects our lake.
Your areas of interest :
PRINT A COPY TO MAIL WITH PAYMENT. You can also choose to print with empty boxes, and fill them in by hand.

Submit the completed form plus annual $25 payment to :             c /o Ruth Smith          40 Bartlett Drive.          Parry Sound, Ontario          P2A 2W8          ruthi@vianet.ca