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

Street Address Line 2

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.