VOSTOK Volleyball Club - Individual Member Registration Form 2019
Submission of this form is an application for membership of VOSTOK Volleyball Club Only.

Membership applications for players under 18 years of age must also be confirmed by the applicant’s parent or legal guardian.
Email address *
Please select the membership category which you are applying for in 2019 *
About Me
First Name *
Your answer
Surname *
Your answer
Gender *
Home Address *
Your answer
Suburb *
Your answer
Postcode *
Your answer
Primary Phone Number *
Your answer
Other Number
E.g. Home, Work or Mobile
Your answer
Email Address *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Are you of Aboriginal or Torres Strait Islander descent? *
Member Declaration *
Required
Parent/Guardian Declaration
Where the applicant is under 18 years of age this form must also be confirmed by the applicant’s parent or legal guardian.
Parent/Guardian Full Name
Your answer
Parent/Guardian Email address
Your answer
Parent/Guardian Phone number
Your answer
Image Permission
Parent/Guardian Declaration
Are you interested to play at Vostok Cups?
Are you interested to play at SVL (Sydney Volleyball League) every Sunday from 02 June till 22 September @ SOP *
Are you interested to play at SVNSW State Cups on? *
Required
Payment
Please select your preferred method of paying the 2019 Membership Application fee *
Vostok Club Bank Account Details
Account name: Vostok Volleyball Club
BSB: 062 213
Account number: 0090 1274
Reference: your full name
A copy of your responses will be emailed to the address you provided.
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