Join the G.A.P's family — support for grandparents and relative caregivers in Philadelphia

⚖ Electronic Signature Disclosure & Consent — Commonwealth of Pennsylvania

By typing your full legal name in the signature field below, you acknowledge and agree to all of the following:

• Legal equivalence. Your typed name constitutes your electronic signature and is legally binding to the same extent as a handwritten (wet ink) signature under the Pennsylvania Electronic Transactions Act (73 P.S. §§ 2260.101–2260.5101), Pennsylvania’s adoption of the Uniform Electronic Transactions Act (UETA), and the federal Electronic Signatures in Global and National Commerce Act (E-SIGN Act, 15 U.S.C. § 7001 et seq.).
• Intent to sign. You are voluntarily and intentionally signing this Membership Application and agree to conduct this transaction electronically with Grands As Parents, Inc.
• Accuracy of information. You certify that all information provided in this application is true, accurate, and complete to the best of your knowledge.
• Membership obligation. If applicable, you understand and accept the membership pledge of $120.00 per year (payable as $10.00 per month) as described herein.
• Record retention. You understand that Grands As Parents, Inc. will retain an electronic record of this application, which may be reproduced as required.

If you do not agree to the terms above, do not submit this form. You may request a paper application by contacting us at (215) 236-5848 or grandsasparents1@gapsnow.org.