Test Membership Form

In this version I removed the fields for entering the other adult info for a family membership.

CCC Membership Application Form

Membership Type

Are you a new or renewing member with a single or family membership?

Emergency Contact

Please provide an emergency contact name and phone number - just in case.


This is a 100% volunteer run club. Would you help?



I understand there may be risks of personal injury while talking part in Club activities, and that the trip leaders are not necessarily certified or trained in first aid. I agree to carry out appropriate safety precautions. I understand that photographs of our group activities may be published on our website, in our newsletter, or on our Facebook page. By clicking the "I Agree" button below, I agree to these conditions and hereby release the Cataraqui Canoe Club from all liabilities related to Club activities.

Almost Done!


Tell us anything you want!

Thank you ... and click Send below!