Wellington Underwater Club 2018-19 Membership (New Members)
Wellington Underwater Club Incorporated
Membership for the period from 1st September 2018 to 31st August 2019
Subscription Details - 40NZD (new members only)
If you have previously completed an online form or if you are or have been a WUC member please use the membership renewal form 2018/19.
Subscription for new members is 40NZD and payments can be made directly to the Club's bank account:

ANZ, Lambton Quay, account:
01-0505-0088263-00
Please include your name for reference

Don't hesitate to contact WUC by email to wellington.underwater@gmail.com with any questions.

Type of Payment
Payment details
Please note name of committee member who received the payment in the box below.
Your answer
Personal Details
First Name *
Your answer
Family Name *
Your answer
Street Address *
Your answer
City *
Your answer
Suburb *
Your answer
Postal Code *
Your answer
Tel (mobile) *
Your answer
Home ph (optional)
Your answer
Email *
Your answer
What is your age? *
Please Note
Email addresses are used for the purpose of organising Club activities and will be shared between Club members participating in events and the Club committee. Wellington Underwater Club is affiliated to the New Zealand Underwater Association (NZUA) who updates all members through regular email newsletters. Please opt in to receive updates from New Zealand's Underwater Sports umbrella organisation. You can also follow NZUA on Facebook.
*
Emergency Contact
Full Name *
Your answer
Relationship *
Contact phone number *
Your answer
Please provide a second contact if your main emergency contact is your regular dive buddy
Full Name, Relationship and Contact phone number
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service