Registration Type*-Member RegistrationNon-Member RegistrationTotal $ 0.00 CAD Name* Email* Address* City* Province* Postal Code* Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name The Regina Community uses the transaction provider "Stripe" for website transactions. The billing name "Regina Community Clinic" will appear on your credit card statement. We value your privacy. We will use the information you have provided to provide you with a response. We will protect your information and report to you immediately, in case of a breach. We will not sell or divulge your information to any other party. If you have questions about any of this, please direct them to: Regina Community Clinic at 306.543.7880.EmailThis field is for validation purposes and should be left unchanged.
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