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Become a Member

First Name(s)
Maximum 50 characters.
Last Name
Maximum 50 characters.
Preferred Name
Maximum 50 characters.
Email
Maximum 80 characters.
Secondary Email
Maximum 80 characters.
Last Logged In
Gender
Date of Birth
Open Calendar
Occupation
Maximum 100 characters.
Skills
Any skills that may be of interest to the club Maximum 400 characters.
Address Line 1
Maximum 50 characters.
Address Line 2
Maximum 50 characters.
Suburb
Maximum 50 characters.
Town / City
Maximum 50 characters.
Postcode
Maximum 10 characters.
Country
Maximum 50 characters.
Home Phone
Maximum 30 characters.
Work Phone
Maximum 30 characters.
Mobile Phone
Maximum 30 characters.
Dietary Requirements / Allergy Notifications



Select any specific dietary requirements or allergy notifications the club needs to be aware of.
Emergence Contact Detail
Name and phone number of emergency contact. Maximum 1000 characters.
Joining Comments
Any other comments about joining for the club, including members you know, why you want to join etc. Maximum 1000 characters.
Security Check

08 Aug 2020 03:05