The Online Registration Form *must* be completed and a CCN Login I.D. assigned before the Society can accept this acknowledgement.

CCN User Agreement Part 3: Acknowledgement

[Applicant must print or write the material below].

I have read and agree to accept all of the provisions of the User Agreement for Chebucto Community Net this ____ day of ____, _____





Signature (Print Name below)
CCN Login I.D. ______



YOU MUST include a photocopy of ID with your signature or a personal cheque to confirm your identity for your account to be activated. Issuance of a User Login I.D. will constitute acceptance of this agreement by the Society.


[If Applicant is under the age of 18, the parent or guardian must also sign below].

Applicant Birthday: Day: ____ Month: __________ Year: ______

[Parent must print or write the material below]

I am the parent or guardian of .........................[name of user under age 18]. I have read and agreed to all of the provisions of the User Agreement for Chebucto Community Net including clauses 16 and 17 this ____ day of ____, _____

My cheque for membership dues for the Applicant or my signed confirming identification accompanies this acknowledgement.





Signature (Print Name below)



Signed User Agreements should be mailed to:
Chebucto Community Net
Room 006, Chase Building
Dalhousie University
Halifax, N.S.
B3H 4R2
Canada

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