Membership Application Form

Name *

First Name

Last Name

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

First Name

Last Name

Consent *

By ticking 'I AGREE', I consent to my information being shared with the Committee for review and a decision on my membership. If accepted, I agree to abide by the Constitution, By Laws, Regulations and club code of conduct. I agree to pay membership fees within 7 days of being notified of my membership acceptance.

I agree