Name: ___________________________________________________________________________
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Address: __________________________________________________________________________
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__________________________________________________________________________
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__________________________________________________________________________
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Telephone: __________________________________
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Email address for newsletter and other notifications: ______________________________________
Annual Dues
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Adult membership: CDN$40.00
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Junior membership (16 and under): CDN$25.00
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Family membership: CDN$40.00, plus $25.00 for each additional person
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Names of additional family members: ________________________________________
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________________________________________
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Please do not publish my address on the OMSS Membership List
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Date of birth: _____________________