Registration Form OSGA YES! I would like to join Ontario Senior Games Association (Information provided will be used strictly for OSGA and District use unless otherwise instructed) (If you are a returning member please log into your account to renew your membership.) iMembersDB Login Applicants are asked to complete the following information. Starred items(*) are required. After completing this form, click ‘Submit’. A copy of this application will be emailed to you. Or you can also print this form and mail it to the address below. Member Information: * First Name: MI: * Last Name: Prefix: Nickname: Gender: Male Female Not Given Prefer not to identify *DOB: District: Addington - District 10 Akwesasne - District 08 Brampton - District 19 Brant - District 25 Chatham - District 33-A Cochrane - District 02 Dryden - District 01-A Dufferin - District 19 Dundas - District 08 Durham - District 13 East York - District 16 Elgin - District 31 Elliot Lake - District 03-A Essex County - District 32 Etobicoke - District 17 Fort Frances - District 01-A Frontenac - District 10 Glengarry - District 08 Grenville - District 09 Grey Bruce County - District 27 Haldimand - District 25 Haliburton - District 11 Halton - District 21 Hamilton - District 22 Hastings - District 10 Huron - District 29 Kawartha Lakes - District 12 Kenora - District 01-A Kent - District 33-A Lambton - District 33 Lanark - District 09 Leeds - District 09 Lennox - District 10 London - District 30 Middlesex - District 29 Mississauga - District 20 Muskoka - District 11 Niagara - District 24 Nipissing - District 03 Norfork - District 25 North Lanark - District 07 North Peel - District 19 North York - District 15 Northumberland - District 12 Ottawa - District 06 Oxford - District 31 Parry Sound - District 04 Perth - District 29 Peterborough - District 12 Prescott - District 08 Prince Edward - District 10 Renfrew County - District 05 Russell - District 08 Sault Ste. Marie - District 03-A Scarborough - District 16 Simcoe County - District 28 Stormont - District 08 Sudbury - District 03 Superior - District 03-B Temiskaming - District 02-A Thunderbay - District 01 Timmins - District 02-A Toronto - District 16 Waterloo - District 26 Wawa - District 03B Wellington - District 26 Wentworth - District 22 Windsor - District 32 York Region - District 14 General I do not know my District Mailing Address: * Address1: (Address) Address2: (Ste/Suite) * City: County/Region: Province: *Postal Code: Country: CANADA Phones(s) Home Phone: Cell Phone: * EMail: Emergency Contact Information: * First Name: * Last Name: * Telephone #: * EMail Address: Activity Interests: Alpine Skiing Badminton Bid Euchre Billiards Bocce Carpet Bowling Contract Bridge Cribbage Curling Cycling Darts Duplicate Bridge Euchre Five-Pin Bowling Floor Shuffleboard Golf Ice Hockey Lawn Bowling Nordic Skiing Pickleball Skating Slo-Pitch Swimming Table Tennis Ten-Pin Bowling Tennis Volleyball Walking/Running How did you hear about us? Friends Sports Club Senior centre FaceBook Advertisement (who) Other Sources, please specify Members are entitled to access to member-only website features, and participation in all OSGA and District events. Our membership is $10.00 for everyone. Expires March 31. 75 Bobmar Road Scarborough, ON M1C 1C8 (905) 232-8581 E-mail: firstname.lastname@example.org Westwind Systems, dba iMembersDB, LLC is collecting the above personal information on behalf of Ontario Senior Games Association (OSGA) in order to process your online application for OSGA participation. Our organizations do not sell your personal information. The Registrant authorizes the OSGA to collect and use personal information about the Registrant for the purpose of receiving communications and the purposes described in the OSGA policies relating to privacy. The Registrant grants permission to OSGA to photograph and/or record the Registrant’s image and/or voice on still or motion picture film and/or audio tape, and to use this material to promote the OSGA through social media, newsletters, websites, television, film, radio, print and/or displays. The Registrant understands that they waive any claim to remuneration for use of audio/visual materials used for these purposes. Permission may be withdrawn at any time by contacting the OSGA’s Privacy Officer. The Privacy Officer will advise the implications of such withdrawal. Please check the "I Consent" checkbox below to allow us to collect, use, and disclose your personal information as described above. I Consent If you are paying by check, please print the completed application now. Click here to print. Thank you for applying for membership with Ontario Senior Games Association. To complete your membership application, a payment of $ is now required to complete you membership.