LAKE HURON FISHING CLUB

MEMBERSHIP PURCHASE FORM

P.O. BOX 355, SOUTHAMPTON, ONTARIO, N0H 2L0

 

Please complete the following form and click the Submit Button.

You will then be taken to our secure PayPal page to complete your Membership purchase.

You will then be taken to the Secure PayPal site to place your order.

Renewal:    New: Type of Membership:  


Last Name:

First Name:

Street Address:

City:

Province or State:

Postal or Zip Code:

Phone Number:

Email Address:
 

Age:

Occupation:
 

Newsletter by Email: Yes   No


Junior 1 Year: $15.00

Adult 1 Year: $35.00

Adult 3 Year: $90.00

Family 1 Year: $40.00

Family 3 Year: $105.00

Corporate 1 Year: $40.00

Corporate 3 Year: $105.00


 

 


INFORMATION FOR FAMILY MEMBERSHIPS

Name of Spouse:        

Dependent Children:    Age:

                                        Age:

                                        Age:

                                        Age:


CLUB INVOLVEMENT

I wish to be a supporting Member Only. No Calls Please:

I wish to help in the following areas:
 

Derby Weigh Station

Stream Enhancement

Trout Hatchery

Salmon Hatchery 

Derby Committee

 Computer Work

Kincardine Docks

Where Ever Needed

Additional Comments:

 

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