Membership Form

We are a social club run by a committee of volunteers, if you would like to be added to or removed from our membership database please fill in the fields below and we will update our database.

Choose an option: Add Remove

Name:


Email Address:


Cell Phone:




ADDITIONAL INFORMATION (Optional)

Any additional information you would like the club to be aware of e.g. DIABETIC, ASTHMATIC, INJURIES.

Emergency Contact Name:


Emergency Contact Phone:


Additional Information:






The club will hold this information and endeavor to keep this confidential, and use in case of emergency or contacting you on club matters.
You may be asked for updated information from time to time to keep our records updated.