Club Roots

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City Province Postal Code

Knowing your birthday and your preferred pronoun helps us to know a little more about our Club Roots Members and which promotions might be of more interest.

Your Birthday*

Preferred Pronoun

He
She
They

How did you hear about Club Roots

Favourite Roots Product

Comments or Questions

Please confirm before sending*

I am not a robot.

Phone

This field is for validation purposes and should be left unchanged.

Join Club Roots

Roots Refills

Refer a Friend