Public:BecomeAMember
From HLSA
HOMEBASED LEARNING SOCIETY OF ALBERTA 2009-10
Please print (see printable version in the toolbox column on the left) this form and send $25.00 membership fee to HLSA, 9748 - 86 Avenue, Edmonton, Alberta, T6E 2L4. Once your membership is processed you will receive a membership card and receipt in the mail and the latest Calendar of Events.
Parent/Guardian Surname ________________________ First Name ________________________________
Parent/Guardian Surname ________________________ First Name ________________________________
Phone Number ____________________ E-mail _______________________________
Neighbourhood _____________________________________
Address ____________________________________________________Postal Code _______________
| Names of children | year of birth | M/F |
|---|---|---|
Do you want the above information (except your address and children's names) on the phone list which is circulated to members only? yes/no
Do you want to receive mailings by email? yes/no
Do you want to join the HLSA e-group? yes/no
Are you currently homeschooling? yes/no
Would you like to have the membership fee waived? yes/no
Acknowledgement of Non-Liability of HLSA Members
I, _____________________________, become a member of the Home-based Learning Society (HLSA), with the full understanding that HLSA is a non-profit society, registered under the Societies Act of the Province of Alberta. Accordingly, I understand that, as provided by the Societies Act of the Province of Alberta, all members of HLSA are immune from personal liability in relation to all activities and events related to the Society.
I undertake that neither myself, any of my heirs, family members or any other relatives will hold HLSA, or any of its members, including executive members, liable for any adverse outcome, such as accidental injury, or accidental death or loss of property, occurring in the course of my or my family's participation in HLSA related activities or events.
Finally, I acknowledge that I and any other adult members of my household bear primary and ultimate responsibility to be vigilant for the behaviour and well-being of my child(ren) in the course of all HLSA activities or gatherings.
Member Signature :_________________________________________________
Date: ___________________________________
Witness Signature: _________________________________________________
