ADULT MEMBERSHIP APPLICATION

* Required

Application type

New Memebership Application

Renewing Memebership Application

MEMBER'S DETAILS

First name

Last name

Phone

Date of birth

Street Address

City

State

Postal code

Emergency contact name

Emergency contact phone

I have read, understood and agree to be bound by the constitution and rules of CTG Inc. as they apply for the duration of my/the youth applicant’s membership, including prompt payment for any fees owing.

I grant to CTG Inc., and its representatives, the right to take still and moving images of me/the youth applicant and authorise CTG Inc. to copyright, use and publish these in print and/or electronically. I agree that CTG Inc. may use such images with or without my name/ the youth applicant’s name for any lawful purpose including publicity, illustration, and advertising and for web content.