Members Application Form
Port Macquarie Pacers Running Club Incorporated Individual Members Application Form
Memberships expire 31 August 2019. New members $75 (includes a singlet in your choice of size). Returning members $40, Children $15. All memberships are subject to committee approval, as outlined in the club constitution.
Gmail address (Our calendar and members area require a gmail address. Please supply a gmail address if you wish to get access to both the calendar and members website)
Date Of Birth
Emergency Contact Name
Emergency Contact Address
Emergency Contact Phone
Payment Method (in order of our preference)
Credit Card (in person from a committee member) (preferred) (This is the only method that gives you a receipt, so we recommend paying by card).
Bank Transfer (Newcastle Permanent Building Society BSB 650 000 Acct 528455804)
Womens Singlet (new adult members only)
Mens Singlet (new adult members only)
By ticking this box i acknowledge the risks and potential injury that may occur from participation in the Port Pacers Running Club and indemnify the club from those risks and any obligations. I also confirm i have read and agree to abide by the Member Protection Policy Document and the Code of Conduct document and am agreeing to apply for a non-refundable membership of Port Macquarie Pacers Running Club Incorporated. The documents in question can be found here
A copy of your responses will be emailed to the address you provided.
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