Broome Sailing Club - Membership Application

Membership Application Form

Broome Sailing Club's membership types and fees are located in: Fee Structure.
Your application will be reviewed by the Committee and if accepted then you will be invoiced for your fees by the club.

Membership Type: Ordinary Family (***) Non-Sailing Reciprocal Youth (under 18)

Your First Name:

Your Last Name:

Gender: Male Female

Your Date of Birth: (dd/mm/yyy)

Occupation:

Full Name of Guardian: (if under 18)

Yachting Australia #: (if applicable)

Postal Address:

Suburb:

State:

Post Code:

Phone:

Mobile:

Your Email Address:

Confirm Your Email Address:

Guardian or next of kin contact details:

Address:

Suburb:

State:

Post Code:

Phone:

Mobile:

Email:

If summer is hot, winter is? NB: Security Question

For office use only NB: Do not put anything in this field.

Message:

*** for Family Membership the additional Name(s), Gender(s) and DoB(s) should be added to the Message box above.

This form uses Huggins' Email Form Script

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