Join Now – Rebounders Canada

JOIN NOW

Rebounders Canada is a registered Canadian charity offering support and social opportunities to adults who are living with the long-term effects of childhood cancer. This Membership Form must be filled out and signed to participate in Rebounders activities.

Some fields are optional.

First Name

Last Name

Address

Apt/Unit #

City

Province

Postal Code

Home Phone

Cell

Birth Date

Your Diagnosis

Year

Daily Challenges Faced

Caregiver's Contact Information (Name)

Relationship (optional)

Phone (optional)

I give permission to have the above information included in Rebounders Membership Directories.

Yes No

I give permission for photos of myself to be included for purposes of Rebounders promotion and communications, including, but not limited to newsletters, website, brochures, videos and the Rebounders Facebook page.

Yes No

I consent to receive information from Rebounders by email.

Yes No

c/o 150 King St. W.

support@rebounders.ca

Rebounders Canada is a registered Canadian charity offering support and social opportunities to adults who are living with the long-term effects of childhood cancer. This Membership Form must be filled out and signed to participate in Rebounders activities.

Some fields are optional.

THRIVING, NOT JUST SURVIVING

Connect with us

Find Us Here

All Rights Reserved © 2021

c/o 150 King St. W.

support@rebounders.ca

Rebounders Canada is a registered Canadian charity offering support and social opportunities to adults who are living with the long-term effects of childhood cancer. This Membership Form must be filled out and signed to participate in Rebounders activities. Some fields are optional.

THRIVING, NOT JUST SURVIVING

Connect with us

Find Us Here

All Rights Reserved © 2021

Rebounders Canada is a registered Canadian charity offering support and social opportunities to adults who are living with the long-term effects of childhood cancer. This Membership Form must be filled out and signed to participate in Rebounders activities.

Some fields are optional.