Big Rideau Lake Association

1. Registration » 2. Billing

Membership

Annual Membership Fee *

Member Info

First Name *
Last Name *
Partner
Email *
Address *
City *
Postal Code *
Province *
Phone *

Lake Location

Address
Postal Code
Phone
Local (911) Reference #
Description

Donations to further support

Fireworks	$
Environment	$
Govt/Marine	$
Recreation	$
Other	$

BRLA Programs of Interest

Environment Issue
Gov't/Marine Affairs Issue
Recreation	Sailing Fireworks Regatta Children's Day Camp Teens Social Events

Payment Method

Method of payment *	If your cheque is not received within 30 days your membership will be put on hold.

Children Info

Children's Names and Birthdays

Your personal information will be used by the BRLA to provide services to you as a member. It will be treated confidentially and will not be shared without your prior consent.