Membership Form

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Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date*
MM slash DD slash YYYY
Would you like to join our mailing list?
If selected, you will receive emails from us from time-to-time. You may unsubscribe at any time.
- Yes, subscribe to the mailing list
Automatic renewal?
If selected, we will charge your card automatically each year. You may cancel at any time by emailing info@pdome.org.
- Yes, enable automatic renewal
Terms and Conditions*
The terms and conditions are the Pleasure Dome Code of Conduct, Anti-harassment Policy and Procedures, and Diversity Inclusion Statement.
- Yes, I agree to abide by the terms and conditions of membership to the organization
Membership Dues
Total
Annual Membership Dues
$ 0.00 CAD
Credit Card
Card Details
Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.