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ADDRESS INFO
Membership Type *	GBCC 1 Year Membership ($20.00) Greater Baltimore Canoe Club Annual Membership Dues
Payment System *	PayPal secure credit card payment
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Choose a Login Name (User ID) * It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Choose a Password * Must be 4 or more characters
Confirm your password * Enter password again
Family Menbers List other Family members names
Company Name If this is a corporate membership add you company's name Here
Home phone Home Phone Number
Work Phone Number
Other Phone Number add your cell or other numbers that you could be reached at by fellow members here
Street *
City *
State *
ZIP *
Country *