Membership – The Grey Area

Membership Level *

Basic $25

Tier 1 $275

Tier 2 $525

Tier 3 $1025

Total Amount

Membership

First Name *

Last Name *

Primary Role *

I have a neurological condition

I care for someone with a neurological condition

I wish to support others with neurological conditions

Primary Nationality *

Date of Birth *

Phone

Street Address / PO Box *

City *

Postal Code *

Country *

How you wish to be involved

Please indicate your purpose for Registering as a Member (tick all that apply):

Your Focus *

Supporter: I am registering as a basic member supporter interested in all The Grey Area initiatives

Early Access: I am registering as I would like to receive early access and information for all events and programs The Grey Area provides

Financial Assistance: I am registering for the purpose of eligibility for financial assistance

Advisement: I am registering for access to the medical resources and general advisory services The Grey Area offers

Please indicate your interests in participation in The Grey Area programs, fundraising, educational initiatives etc. (tick all that apply):

Involvement Interests

Fundraising

Events

Marketing

Educational support/outreach programs

Corporate Liaison

Youth Leadership/Awareness

Volunteer/volunteer coordinator

Other

Participation Note

Please briefly provide a personal statement of how you or a friend/family member has been impacted by neurological diagnoses and/or any valuable information you wish for us to know about you or how you hope to benefit from The Grey Area:

Personal Statement

Commitment and Confidentiality

By signing below, I confirm that (please tick all boxes):

Membership Commitment *

I support the mission and objectives of The Grey Area.

I will abide by the constitution, policies, and Code of Conduct of the The Grey Area.

I agree to pay all membership fees as may be applicable on or before September 1st of each year of Membership.

I understand that Membership may be revoked for conduct contrary to the The Grey Area’s values or Cayman Islands laws.

I consent to my contact details being held securely for the purposes of Membership administration and organisational communication.

Please indicate that you agree and understand the following confidentiality terms and conditions

Confidentiality Clause *

I understand and agree that any sensitive, personal, or organisational information provided by me to The Grey Area or that I may access or become aware of through my Membership, volunteering, or sponsorship with The Grey Area will be treated as strictly confidential and will not be disclosed to any person or entity without the prior written consent of the competent parties, except as required by law.

I understand that this obligation continues beyond the duration of my Membership or affiliation with the organisation.

Miscellaneous

Have you ever been convicted of a crime in the Cayman Islands

Criminal History? *

NoYes

Sorry, we do not accept memberships with criminal history

How did you hear about us?

Payment Options

[x] I will send payment by my banking app or check