Mildura Royals Club Inc. - New Membership Form

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(valid from Dec 2024 to Dec 2025)

Email Address *

Title *

Mr.

Mrs.

Prefer Not to Say

First/Given Name *

Last/Sur Name *

Full Names of Family Members (for family membership)

Full Address (e.g. 18 James Ave, Mildura 3500)
*

Mobile Number (e.g. 0451 510 000)
*

Activities of Interest

Game Nights

Workshops, Seminars, Educational Talks

Social Events and Parties

Volunteering and Community Service

Dinning and Culinary Events

Travel, 4X4 drives, Camping, Exercusions

Other:

Sports of Interest

Cricket

Soccer

Volleyball

Badminton

Table Tennis

Track Athletics

AFL

Zumba, Fitness Activities, Gym etc

Lawn ball

Net ball

Hockey

Other:

Bank Details

Account Name: Mildura Royals Club

BSB: 083004

Account Number: 726723814

Membership Type *

Single $20

Family $40

$20/year (Individual)

$40/year (Family)

Membership Fee Paid?

Yes

Receipt no *

Disclaimer: I acknowledge that by completing this membership form, I am a legal person and resident of Sunraysia region and the State of Victoria, Australia. I agree to provide a proof of identity to evidence the residency upon request. I will abide by the conditions and the model rules for an incorporated association as per the Associations Incorporation Reform Act 2012 adopted by the Mildura Royals Club Inc.
*

Agree

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