Lifetime Membership Fee: Regular ($25.00), Self-Advocate ($5.00)Name(Required) First Last Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Alt. PhoneList the names of family members in the same household and year children were bornNameYear of BirthHas Down Syndrome Yes No NameYear of BirthHas Down Syndrome Yes No NameYear of BirthHas Down Syndrome Yes No NameYear of BirthHas Down Syndrome Yes No NameYear of BirthHas Down Syndrome Yes No In support of our mandate, members are invited to volunteer in some way. Are there any way(s) you would like to contribute or get involved?Which of the following describes your relationship to GVDSS? Adult (19 years or older) who has Down syndrome (Self Advocate) Parent(s) or immediate family of an individual who has Down syndrome Grandparent(s) or other relative of an individual who has Down syndrome Friend, supporter or advocate of an individual who has Down syndrome Educational or Medical professional; supporting community member Other Photo & Information ReleasePlease read the release form and complete the required fields Release Approval*(Required) I hearby grant the Greater Victoria Down Syndrome Society permission to send me printed materials, email and other information related to its mission. I understand that I may “opt out” of receiving any form of communication, at any time, for any reason I hereby grant the Greater Victoria Down Syndrome Society permission to take photographs of all members of my family during society sponsored events. I also grant permission to the Greater Victoria Down Syndrome Society to copyright, use and publish the same in print and/or electronically. I agree that GVDSS may use such photographs with or without names and for any lawful purpose, including for such purposes as publicity, illustration, advertising and Web content. Opt Out: Please remove me from all mailing Please do not photograph my family members Electronic Signature(Required)Type full nameWe will not sell or share personal information with any third parties. We will use the information to contact you about services or events that are relevant to the Down syndrome community. Payment can be made via cash/cheque or via PayPal at the GVDSS websiteCAPTCHA