Burleigh Heads Rugby League Football Club Inc MEMBERSHIP APPLICATION First Name……………………………………………………Surname………………………………………………………………. Residential Address…………………………………………………………………………………………………………............ …………………………………………………………………………………………………P/code……………………………………… Postal Address……………………………………………………………………………………………………………………………. Email…( so we can send you gifts)……………………………………………………………………………………………… D.O.B (so we can send you a card) ………../…………/………….. Phone……………………………………………………………… Mobile………………………………………………………………. ID………………………………………………………………………Type………………………………………………………………… 1 year Supporter Sub Club Water Polo I am over the age of eighteen (18) years and desire to become a member of Burleigh Heads Rugby League Football Club Inc., and request you enter my name on the Register of Members. I understand that my membership application is subject to the acceptance of the Board of Directors. I have not been expelled or suspended from any other club. I agree to be bound by the provisions of the Rules of Association and any rules or by-laws of the Club from time to time in force. In signing this application I agree to accept a duty of care for my actions and will not hold Burleigh Heads Rugby League Football Club liable for my actions whilst in or representing this Club.
By giving my email address or mobile phone number I realise the Club may send promotional material occasionally which I can opt out of. I understand bonus points are club property and are only to be used or accrued by me as a financial member
By signing I agree to the above conditions: Proposer Name _______________________
Proposer Signature________________________
Seconder Name _______________________
Seconder Signature________________________
Signature of applicant _________________________
Date___/____/_______
Once completed, this Page is to be given to Burleigh Bears Reception Staff for processing
