AQUAFORCE SWIMMING CLUB MEMBERSHIP FORM

MEMBERSHIP DETAILS Person 1 Registration Type: New member Renewing member Ive never been with a swimming club Transfer from another club SNSW membership No.:____________________ Swimmer Non-Swimmer

Membership type: (Select one): Personal Details: Surname: Medical Conditions: Address: Mailing Address (if different):

Given Names:

Date of Birth:______________

Australian Citizen: Yes / No (please circle)

Gender: Male / Female (please circle) Post Code: Post Code:

Telephone (H): _____________________ (W) :_______________________ (Mobile):____________________ Email Address(es): __________________________________________________________________________________________ Person 2 Registration Type: New member Renewing member Ive never been with a swimming club Transfer from another club SNSW membership No.:____________________ Swimmer Non-Swimmer

Membership type: (Select one): Personal Details: Surname: Medical Conditions: Address: Mailing Address (if different):

Given Names:

Date of Birth:______________

Australian Citizen: Yes / No (please circle)

Gender: Male / Female (please circle) Post Code: Post Code:

Telephone (H): _____________________ (W) :_______________________ (Mobile):____________________ Email Address(es): __________________________________________________________________________________________ Person 3 Registration Type: New member Renewing member Ive never been with a swimming club Transfer from another club SNSW membership No.:____________________ Swimmer Non-Swimmer

Membership type: (Select one): Personal Details: Surname: Medical Conditions: Address: Mailing Address (if different):

Given Names:

Date of Birth:______________

Australian Citizen: Yes / No (please circle)

Gender: Male / Female (please circle) Post Code: Post Code:

Telephone (H): _____________________ (W) :_______________________ (Mobile):____________________ Email Address(es): __________________________________________________________________________________________

PLEASE COMPLETE REVERSE SIDE OF FORM

Parents/guardians (applicable if member is under 18 years) & Non Swimming Members* Mother/Guardians Surname: Given Names: Occupation (Optional): Non-Swimmer membership Are you a committee Member (Circle): Telephone (H): (W): (Mob): Email: Alternate Emergency Contact Name:________________________________Telephone:_____________________
*Every family must register one Non-Competitive member who is over the age of 18years in order to be covered by Swimming NSWs insurance policy, be protected by the Rules of AquaForce Swimming Club and have voting rights at those meetings where such voting is entitled by the constitution.

Father/Guardians Surname: Given Names: Occupation (Optional): Non-Swimmer membership Yes / No Are you a committee Member (Circle): Telephone (H): (W): (Mob): Email: Yes / No

DECLARATION BY MEMBER (OR PARENT/GUARDIAN, IF MEMBER(S) IS/ARE UNDER AGE 18 YEARS)

I, the undersigned, acknowledge that it is a condition of acceptance of my membership application that: I agree to abide by the rules, regulations and policies of AquaForce Swimming Club and Swimming New South Wales (SNSW),Swimming Australia, the relevant District Swimming Association and the relevant club including Swimming Australia's AntiDoping, Member Protection, Child Welfare and Privacy Policies (available at www.swimming.org.au). I Agree to abide by the AquaForce Swimming Club & Swimming Australia Code of Conduct. I authorise the club to publish suitable photographs taken of me or my child and results in official programs, newsletters, websites or any other AquaForce Swimming Club produced documents. I will assist and support the committee, coaches and club captains of the Club wherever possible to ensure that the Club continues to run smoothly and achieve its objectives. I give permission to the coaching team to conduct fitness training for members listed in this form.at a suitable and safe location. I will participate in the activities of the Club, including but not limited to: assisting in volunteer duties (e.g. time-keeping) allocated to the Club at approved meets; assisting in the running of Club nights/days; and assisting in official Club fundraising activities. I understand that when I or my child competes in a swimming event that I am / they are representing the Club and should be attired in the correct club uniform. I agree that all members must take responsibility for the supervision of their children at training, club races and approved meets. I authorise the email address(es) and telephone number(s) supplied above being disclosed to other members of the Club.

Signature of Member or Parent/Guardian: ______________________________Date:____________________

FEES FOR 2012 YEAR (1 JAN 2012 TO 31 Dec 2012)

Member Category Non-Swimmer Swimmer
Notes:
The Club fee for the first year of membership is waived. AquaForce Swimming Club (the Club) has registered for an ABN but not for GST therefore we are not required to charge GST on coaching fees. You must be registered as a Competitive Swimmer to participate in Swimming SNSW and MSW approved meets. Photocopy of your birth certificate is required for swimmers registering with SNSW for the first time. This is not necessary for reregistrations or transfers from another Club. Cash Cheque Electronic Fund Transfer to: Bank: Commonwealth bank Account No.: 06 2424 10539086 Account Name: AquaForce Swimming Club Inc. When making payments, please enter in the description field REG followed by your last name (e.g. REG Smith). This information will appear on our bank statement.

Total $ 0 0

Payment Method:

Cheque payable to AquaForce Swimming Club