THRC Community Membership Purchase and Renewal
Contact Information
First Name
Last Name
Home Address
City/Town
Postal Code
Email Address
Home Phone Number
Cell Phone Number
I agree that THRC may use this email address to contact me for renewals, information sharing, events, current issues, professional learning, late fines and overdue reminders, if applicable. I may unsubscribe at any time.
Yes
No
How did you hear about THRC?
Please select...
Social Media
Email
Friend
Word of mouth
Work
Other
Liability Statements
I understand that I am responsible for any resources borrowed from The Halton Resource Connection.
Yes
I understand that I am responsible for returning equipment to The Halton Resource Connection in the same condition that it was borrowed
Yes
I understand that I am financially responsible for damage done to equipment or fines incurred on overdue items. In the case of outstanding fees/fines I will pay in person or provide credit card information.
Yes
I understand that The Halton Resource Connection accepts no responsibility for injury caused by equipment borrowed.
Yes
THRC Annual Membership
1 Year Membership (New Membership)
1 Year Membership (Renewal)
Payment Information
Name on Card
Card Number
MM
YY
Code
Billing Email
Total Amount Due ($CAD)
Your card will be charged this amount when the form is submitted.
Contact Information