Registration & Re-Commitment Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required 100 Guys Who Share – Yarmouth County Registration & Re-Commitment Form Commitment: With my signature below, I am agreeing that the information I provide below is accurate and true. I am pledging to participate in 100 Guys Who Share – Yarmouth County, and I am making a personal commitment to contribute $400 each calendar year ($100 quarterly) to local nonprofit organizations serving the Yarmouth County region. I agree to donate each quarter to the nonprofit organization selected by the group’s majority vote. If I am unable to attend a quarterly meeting, I will either send my check with another attending member to deliver on my behalf, mail it as requested after the meeting, or pay online, if that option is presented. I also acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for 100 Guys Who Share – Yarmouth County. I understand my personal contact information is strictly confidential and I understand it will not be shared or distributed to an outside third party without my expressed consent. If 100 Guys Who Share – Yarmouth County chooses to publish a Membership Directory, I agree that my contact information be included in that directory. YesNo Member: First Name * Last Name * Address City Province or Territory Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code Best Phone Number * Email Address * Date Completed Commitment Forms may be scanned and sent via e-mail to 100 Guys Who Share - Yarmouth County or forms may be completed and turned in at a meeting. (Should you wish to discontinue membership at any time after your four-time commitment, please send an e-mail to info@100guysyarmouth.com, indicating your withdrawal.) Confirm that you are not a bot *