Membership Form

Membership EN

Year :

First and last name:

Family Name

Name

Lake Gagnon address :

(no. and street name): Duhamel, QC, J0V 1G0

Cell phone number or phone at the lake:

Email address 1 :

Email address 2 (optional)

Mailing address (if different)

No. and street name:

City :

Province:

Postal code:

Telephone :

Language of correspondence:

Correspondence and Remous

Comments:

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