Account Signup

Account Information
* Indicates required fields.

First Name*

Last Name*

Email*

Create a Password* Min 8 Characters

Phone*

How did you hear about us?
AgencyHealthcare ProviderFriendsWebsiteOther

Spouse Name*

Year of Death*

Proof of Loss Available Upon Request?

Emergency Contact Name*

Emergency Contact Phone*

Age Group*
20-3030-4040-5050-6060-7070-8080-90

Date of Birth (WF Birthday Club Day/Month)

I have read and agree to the Terms of Membership*

I have read and agree to the COVID Waiver*

Billing Details

Credit Card:

Card Verification Code:

Expiration Date:

Billing Address

Address:

City:

Province:
Please select your stateAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon TerritoryOther…

Postal Code:

Country:
Canada

Shipping Address

Shipping Method:

Shipping is the same as billing