New Member Intake Form There was an error trying to submit your form. Please try again. Your Full Name * Enter your full name. This field is required. Date of Birth * Enter your date of birth, for example 05/09/1970. This field is required. Email Address * Please provide a valid email address. This field is required. Confirm Email Address * Email addresses must match. This field is required. Mobile Number * Please enter your mobile number as 04xx xxx xxx or +61 4xx xxx xxx. This field is required. Residential Street Address * Enter your residential street address. This field is required. Suburb or Town * Enter your suburb or town. This field is required. State or Territory * Select your state or territory. Select an option ACT NSW NT QLD SA TAS VIC WA This field is required. Postcode * Enter a 4-digit postcode, preserving leading zeros. This field is required. Membership Number Leave blank if your membership number has not yet been allocated. This field is required. Would you like to add a spouse or partner to your booking records? * Yes No This field is required. Spouse or Partner’s Full Name * Enter spouse or partner's full name. This field is required. Spouse or Partner's Date of Birth Enter your date of birth, for example 05/09/1970. This field is required. Would you like to add any children, including adult children, to your booking records? * Yes No This field is required. Children’s details #1 Enter one child’s details below. Click + to add another child, or − to remove an extra entry. Child’s full name * This field is required. Childs Date of Birth * Enter your date of birth, for example 10/07/2020. This field is required. Child’s school or study status * Select an option Not yet at school Primary School High School Part Time University Full Time University Other Tertiary Studies – Part Time Other Tertiary Studies – Full-Time No longer Studying This field is required. Children’s details #1 Enter one child’s details below. Click + to add another child, or − to remove an extra entry. Child’s full name * This field is required. Childs Date of Birth * Enter your date of birth, for example 10/07/2020. This field is required. Child’s school or study status * Select an option Not yet at school Primary School High School Part Time University Full Time University Other Tertiary Studies – Part Time Other Tertiary Studies – Full-Time No longer Studying This field is required. I confirm that the details provided are accurate and will advise the Club if they change. I understand the Club may request evidence of age or current full-time study to confirm eligibility for concession rates. * This field is required. Submit member details There was an error trying to submit your form. Please try again.
