Membership Form


9139 39 Ave NW Edmonton, AB T8C 1B1 Charity Registration Number BN 89979 9753 RR0001
Date*

Information of Family Member with Down syndrome
First Name*
Last Name*
Date of Birth*
Gender*
	Female
	Male
	Other

Please indicate the membership type you are applying for: Family $40 Membership to EDSS for the member with DS and their families giving access to register for professional services, programs and communications. Access to the EDSS Resource Lending Library. Private members only Facebook page Exclusive events and learning sessions 1st Year Free Membership to EDSS as outlined in the Family Membership. Available to families of children born with Ds within 12 months from date of registration. Access to Wonder Years workshop Community $40 Membership to EDSS allowing access to community events and communications. Access to the EDSS Resource Lending Library Exclusive events and learning sessions. Voting Add-On $10 provides invitation to the AGM to vote Must be added to one of the above membership options. All memberships are valid for the current calendar year January - December. If you encounter any economic barriers to membership, please reach out to our office for assistance.
Membership Type*
	Family
	1st Year
	Community
	Voting Add-On

Membership Contact Information
First Name*
Last Name*
Street Address*
City, Prov*
Postal Code*
Email*
Phone*
Alt Email
Alt Phone

To connect our diverse membership, it is helpful to find others who speak a language you are familiar with. Please list all languages you speak and if we may contact you for peer-to-peer support.
I am willing to provide peer-to-peer support
	Yes
Languages spoken at home

If the member with Down syndrome lives separately, please provide contact information
Caregiver Name
Phone
Email

I hereby grant the Edmonton Down Syndrome Society permission to use my likeness in a photograph, video, or other digital media in any and all of its publications, including web-based publications, without payment or consideration.
Permission*
	Yes
	No

As per the Canadian Anti-Spam Legislation and General Data Protection Regulation (GDRP), I am providing my Express Consent to being added to a mailing list for EDSS member information. I understand that my consent may be withdrawn at anytime by unsubscribing and/or emailing contact@edss.ca
Consent*
	Yes
	No
Add a donation to my membership invoice $_________


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Phone

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EDSS Membership 2026