GHTA On-Line Registration Registration Name (first) * Name (last) * Spouse (first) Spouse (last) Address (mailing address) * Address 2 (mailing address) City * Province * Select ProvinceONQCNB Country * Select CountryCAUS Postal Code * Phone Number * Email * Email of spouse (if desired) Membership type * New MembershipRenewal Membership Membership fee * Donation (a receipt will be issued for amounts $25.00 or more) (xx.xx) Total Payment (membership + donation) Please associate me with the following Ganaraska Trail Club: * SelectMidlandKawarthaWildernessOrilliaBarrieMad RiverWasaga BeachOro-MedontePine Ridge (Port Hope)Independent Risk acknowledgement By submitting this form, I certify that I have read the Ganaraska Hiking Trail Association Inc. waiver in full, (GHTA Inc. Waiver Form) and that I agree to be bound by it.