Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone *

(###)

###

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Consent to Release Information *

I, the undersigned, give permission for the Atlantic Canada Pipe Band Association to selectively release my mailing information to corporate members, sanctioned highland games and other partners to send related mailings to me. My mailing information is never to be sold.

Yes

No