Membership Application Form
I wish to apply for the following grade of membership of Sunshine Coast Rowing Club(Please refer to the attached “Scale of Fees” for costs, for which you will be invoiced when your Application is received. Please Cross one box for Grade of Membership and one box for preferred method of payment.Your completed “EziDebit” forms must be submitted with this Application, if selected. Please note that all memberships expire on 31st December each year):
Email address *
Membership Type *
Name *
Your answer
Home Address
Your answer
Mobile Phone *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Occupation
Your answer
Rowing Experience
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Emergency Contact Address
Your answer
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