MEMBERSHIP APPLICATION for year to 3rd SEPT 2008
 

NAME: ______________________________________________________________
ADDRESS: ___________________________________________________________
_____________________________________________________________________
EMAIL (print clearly):
PHONE: HOME___________________
WORK___________________
MOBILE__________________ FAX____________________
OCCUPATION_____________________________
AGE____________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  List of boards you ride in order of preference:

SIZE:_________________________

SIZE:_________________________

SIZE:_________________________ 		Which events will you be interested in doing?

NZ CIRCUIT COMPS: YES / NO
CLUB COMPS ONLY: YES / NO
MEETING & SOCIAL: YES / NO
ROAD TRIPS: YES / NO
OVERSEAS: TRIPS YES / NO
  NEW MEMBER: YES / NO

 

 

FEES (circle one)

OVER 18 -$30.00 , 18 or UNDER - $20.00 , FAMILY - $50.00 , SOCIAL - $20.00
  I hereby release the Orewa Longboard Club Committee, Orewa Longboard Club Organisers and Sponsors from any liability for damage or injury to me or my family incurred during any club competition or club event. I agree to accept all decisions made by the Orewa Longboard Club Committee.
 
SIGNATURE:____________________
DATE: ____________

* EITHER POST Application with subs to: 18 TIBER ROAD MILFORD

* Or bring along to club meeting: 1ST WED OF EVERY MONTH @ 7.30pm
OREWA SURF LIFESAVING CLUB
MAIN ROAD, OREWA

email: orewalongboardclub@hotmail.com