Register as a Team of 2-4

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Membership Commitment Form for Teams of 2-4

* Indicates required field

Team Name *

Do all team members give permission to have the name of your team posted on the 100+ Women Who Care Quinte website, Facebook Page, Twitter profile, etc.? *

YES NO

Check the box(es) below to agree to the following statement(s): *

We understand that we are making a commitment to 100+ Women Who Care Quinte to make a quarterly donation of $100, four times per year, which will be given directly to local charities, non-profits and organizations serving the Quinte area. We agree to fulfill our donation commitment even if we did not vote for the charity selected by majority vote. If no one from our team is able to attend a quarterly meeting, we will do one of the following: provide our cheque to another member to deliver in our place; or deliver our donation in person to 100+ Women Who Care Quinte c/o Belleville Chamber of Commerce, 5 Moira St. E., Belleville, ON K8P 2S3 We give permission to 100+ Women Who Care Quinte to use photos that we are in for web content, advertising, etc.

Team Member #1

Name *

First

Last

Phone Number *

Email *

Mailing address (for charitable donation receipts) *

Line 1

Line 2

City

State

Zip Code

Country

Do you grant permission to the Leadership Committee to contact you about 100+ Women Who Care Quinte via email? *

YES NO

Team Member #2

Name *

First

Last

Phone Number *

Email *

Do you grant permission to the Leadership Committee to contact you about 100+ Women Who Care Quinte via email? * *

YES NO

Mailing address (for charitable donation receipts) *

Line 1

Line 2

City

State

Zip Code

Country

Team Member #3 (if applicable)

Name *

First

Last

Phone Number *

Email *

Do you grant permission to the Leadership Committee to contact you about 100+ Women Who Care Quinte via email? *

YES NO

Mailing address (for charitable donation receipts) *

Line 1

Line 2

City

State

Zip Code

Country

Team Member #4 (if applicable)

Name *

First

Last

Phone Number *

Email *

Do you grant permission to the Leadership Committee to contact you about 100+ Women Who Care Quinte via email? *

YES NO

Mailing address (for charitable donation receipts) *

Line 1

Line 2

City

State

Zip Code

Country

Submit

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