URLThis field is for validation purposes and should be left unchanged.New Account SetupUsernamePassword Enter Password Confirm Password Strength indicator User InformationName(Required) First Last Phone(Required)Email(Required) Date of Birth(Required)MMMM123456789101112DDDD12345678910111213141516171819202122232425262728293031YYYYYYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SexMaleFemalePrefer not to AnswerThis field is hidden when viewing the formAgeUsed to automatically apply the junior discount (if under 21)Address(Required) Street Address Address Line 2 City 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 State ZIP Code Membership InformationMembership Category(Required)PremierBasicPay-as-you-goSocial MemberYear You Started Curling(Required)Have you taken a Learn to Curl with us or elsewhere or curled before?(Required) Yes No List me in the Directory(Required) Yes No This field is hidden when viewing the formPremier Membership Monthly RateThis field is hidden when viewing the formBasic Membership Monthly RateThis field is hidden when viewing the formSocial Membership Monthly RateThis field is hidden when viewing the formCurrent Date MM slash DD slash YYYY This field is hidden when viewing the formFirst Day of Sept. re-starts the pro-ration. MM slash DD slash YYYY The year is irrelevant because we subtract that laterThis field is hidden when viewing the formYears to subtract for Pro-rateTo be used for prorationThis field is hidden when viewing the formMonths for Pro-rateTo be used for prorationWould you be willing to occasionally make an additional donation to the club to sponsor a curler who otherwise may not be able to play? Yes No If you select yes we'll only contact you when a situation occurs. WaiverPlease click Add Waiver below to review the waiver and submit your acknowledgment Name Signature Actions Edit Delete There are no Waivers. Add Waiver Maximum number of waivers reached. Code of Conduct AcknowledgmentPlease click Add Entry below to review the club Code of Conduct and submit your acknowledgment Name Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. DisclaimerFees and DiscountsPay-up-Front Fee Price: $0.00 Junior Curler Discount (Under 21 Years Old) $0.00 Senior Curler Discount (65 Years or Older) $0.00 This registration is for an additional Family Member Yes No Please Select an Already Registered MemberAaron BrownAaron RichterabuczkiewiczadachappAdam MelcherAdam SchroederAdele LangloisAdrian Martinezaggiez98Aidan MitchelsonAislinn KellingAlex FilbyAlex LancialAlex MeedAlex WilliamsonAlexander GuydoshAlison PrestonAllen OleniakAlly BittnerAlyssa RoetheliAmanda BartellAmar DesaiAmy ZeinnerAnders PorterAndrea KellsAndrewAndrew DuncanAndrew RussellAnna OliverAnthony MartinezApril McCormackArnieArthur GaglianoAshley McColloughAshley RyanAshley SteffeyAspen Shariff-BeyasuttiekAustin CargolAustin DeMossawleasebarnhardtmichael@gmail.comBen HoppeBen KrechBenjamin KalkBenjamin OzimekBex DuPontBrady BakerBraxton MealeyBrent SchwanBrett BeelerBrett BendeleBrett MitchelsonBrian BarkerBrian BlonsteinBrian MeyerBrian OzimekBrimm WalkerBrittany 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BrownShelley HendershotShelly ChiangShravik SethiSim FordSimeon FordStacey VirdellSteve OwenSteven MitchellSue BrickerSusan ItoTejal DesaiTerri HammonsTEST USERThomas GoddenThomas PronskeTim DeanTim LoomisTim McAleerTim Slagertisha_kerseyTommy LeeTraci McColloughTracie ChanTracy WhiteTravis MooretreverdesautelTrevor EvensonTrina PattersonTrudi WebsterTyValerie GIbson BendelevalurgVanessa BarrientosVanessa DiamosVictoria Levasseurvictoriaozimekwdlawrence73Will BestWilliam AnastassiouZac GranthamZula WhitmerAdditional Family Member Discount $0.00 Payment InformationCoupon Payment Method(Required)Pay Online (PayPal)Pay OfflineThis field is hidden when viewing the formPayment Status (LSCC Use)PaidUnpaidPayPal Fee $0.00 Total Payment MethodPayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name This field is hidden when viewing the formIs Active CurlerThis field is hidden when viewing the formHome Curling ClubThis 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