new membership
registrations
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New Member Registration
Membership Offering:
(select offering)
Adult
Junior
Senior
*First Name:
*Family Name:
*M/F:
** Req'd
*Address:
** Req'd
*Suburb:
** Req'd
*Postcode:
** Req'd
*Birthdate:
(dd/mm/yyyy e.g. 19/07/1949)
** Format?
** Req'd
*eMail Address:
** Format?
** Req'd
Landline Phone Number:
*Mobile Phone Number:
** Req'd
Additional Comments:
I/we agree to abide by the rules and regulations of the club.
I understand and accept that the personal details I am providing will be managed as per the club's privacy policy.
Submit Form
Terms and Conditions:
It is a membership requirement that the Club has your email address
A copy of your registration will be emailed to the provided eMail address.
A birthdate is required for junior members