Lazy Seal Freediving Club - Membership form
Please read first
The first part of this form (Personal details) is mainly optional, but would be very useful for us to keep our database up-to-date and to keep you informed as to what is going on in the freediving community.

The second part (Fees and payment) is compulsory.

The third section (medical statement) is compulsory if you are renewing your membership. If you've started with us very recently, you should have already filled it as part of the New diver form.
Personal details
First name *
Last name *
Street
Suburb
Town
Postcode
Phone - cell *
Phone - home
Phone - work
Gender *
Date of birth *
MM
/
DD
/
YYYY
Nationality *
Email *
Please tick if you wish to receive information from the club by email
Name of emergency contact *
Their relationship to you
Their phone number *
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