BECOME A MEMBER

(Print form below, fill out and mail)

Application Form

YES! I want to support normal birth and enjoy the benefits of ICAN's newsletter.

   ___ Donation of $_________

   ___ $40 Basic Subscriber Canada

   ___ $100 Professional Subscriber (includes your website listing in ICAN website)

   ___ $200 Childbearing Years Subscription (5-Year)

   ___ $400 Childbearing Years Subscription (10-Year)

   ___ $600 Lifetime Subscriber

   ___$2,500 Professional Lifetime Subscriber (includes your website
   listing in ICAN website)

Check or money order enclosed for $__________

Today's Date __________________

Name ______________________________________________________________

Address ____________________________________________________________

City________________________________ Province _______ Zip ______________

Phone ______________________________________________________________

E-Mail _____________________________________________________________

(Please provide e-mail address to receive the free online newsletter.)

Website URL ________________________________________________________

(For professional subscribers only - free listing on our website.)

We thank you for your support!

Make checks payable to: Edmonton VBAC Support Association/ICAN of Edmonton and mail to:
Claudia Villeneuve, 7604-153 Street, Edmonton , AB , T5R 1N4

ICAN of Edmonton and The International Cesarean Awareness Network, Inc. ("ICAN") maintain this website as an online information and communications service. Use of this website is at your own risk. The information contained on or provided through this website is intended for general consumer understanding and education only, is not intended to be, and is not provided as a substitute for professional medical advice. Nothing contained on or provided through the website is intended to be or is to be used for medical diagnosis or treatment. The website is presented by ICAN of Edmonton for the sole purpose of disseminating general health information for public benefit. Always seek the advice of your midwife, physician, nurse or other qualified health care provider before you undergo any treatment or for answers to any questions you may have regarding a medical condition. The website and any information provided on the website are not intended to constitute the practice of or furnishing of medical, nursing, or professional health care advice, diagnosis, consultation or treatment or services in any jurisdiction.

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In no event will ICAN of Edmonton or ICAN, Inc. be liable to you or anyone else for any decision made or action taken by you or anyone else in reliance upon the information contained on or provided through the website.