Member Registration - St.Albert Seniors Association

Membership Registration

This form is for brand new members only! If you are attempting to renew your membership, please use the Member login at the top left of the website and renew your membership there.

"*" indicates required fields

Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Phone Number*

Cell Phone

Email*

Birthdate*

Emergency Contact Name*

First Last

Relation to Emergency Contact*

Emergency Contact Phone*

Are there any medical conditions or medications that we should note in case of an emergency at the facility?*

Yes

If Yes, Please Provide Details*

Do you have any allergies?*

Yes

If Yes, please provide details*

Would you like to keep up to date on all the latest S.A.S.A news by subscribing to our e-bulletin?*

I would like to Subscribe to the e-Bulletin

I already subscribe to the e-bulletin

I would not like to subscribe to the e-bulletin

Photo Consent*

I consent to having my picture used for St.Albert Seniors Association Internal & Promotional Material

Thank you and welcome to the S.A.S.A family. You will receive a confirmation of your membership and be assigned a Key tag (membership number) via email within 2 business days.
If you have not received the confirmation within the time frame please contact us at 780-459-0433 ext. 0.

Membership Registration

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