New Member - Membership form Step 1 of 4 - Personal Information 25% Confirm/Enter Your Personal InformationName(Required) First Last SexPrefer not to AnswerMaleFemaleDate of Birth(Required)MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Year You Started Curling(Required)Please provide an approximate year for when you started curling. If you are new to curling, please enter the current year.Email(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mobile Phone(Required)Secondary PhoneList me in the Directory Yes No This field is hidden when viewing the formSkill Level Skill Level Actions Edit Delete There are no Entries. Add Skill Level Maximum number of entries reached. This field is hidden when viewing the formAge Emergency ContactEmergency Contact Name(Required)Emergency Contact Primary Phone(Required)Emergency Contact Secondary Phone Username(Required)Your username may contain only alphanumeric characters (A-Z, a-z, 0-9) and does not include any special characters or spaces. You will be able to login with your username or email.Password(Required) Enter Password Confirm Password Strength indicator Password Requirements: Passwords must be a minimum of 12 characters long. Passwords may include numbers, uppercase characters, and symbols. Password strength must meet the requirement of at least "Good". Membership TypeYour membership type is predefined by your age.Adult Membership Price: Coupon Youth Membership Price: Locker AssignmentWould you like a Locker No Locker Small Locker - $25.00 Large Locker - $50.00 Waiver & Code of ConductWaiver Please Initial here Actions Edit Delete There are no Waivers. Add Waiver Maximum number of waivers reached. Youth Waiver Name of Parent or Guardian Signature of Parent or Guardian Name of Minor Actions Edit Delete There are no Waivers. Add Waiver Maximum number of waivers reached. VolunteerismThank you for considering volunteering! By opting in, you'll join our dedicated team of volunteers. If you choose to opt out, you can support us with a $60 donation instead. Please select your preference below. Yes, I'd like to volunteer! No, but I'd like to donate $60 instead. Non-Curling/Out of Town (No Leagues) Code of Conduct(Required) I accept the BCC Code of Conduct & Spirit of Curling Total IMPORTANT:The membership fee covers access to our facilities and amenities but does not include participation in leagues. Upon becoming a member, you will have the option to join our leagues and take advantage of the various activities and benefits they provide. Your Membership Profile page will contain all the league information you need, including schedules, registration details, and updates. Detailed descriptions of our leagues can be found under the membership/leagues section, offering a comprehensive overview to assist you in making informed decisions about your league participation.PaymentPayment Type(Required) Credit Card Healthcare Card* - (In-Person Only) *Membership procedures for payment with a Health Care Card: BCC will follow up with an email, specifying dates for payment at the club once the number of participants is determined.Use a Different Billing Address? Yes Payment Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Credit Card Cardholder Name Card Details This field is hidden when viewing the formRequired but HiddenMembership ID NumberThis field is hidden when viewing the formIs Active CurlerThis field is hidden when viewing the formHome Curling ClubThis field is hidden when viewing the formYear at Home Curling ClubThis field is hidden when viewing the formSite IDTotal CommentsThis field is for validation purposes and should be left unchanged.
