MEMBERSHIP FORM Membership Personal Details First Name * Last Name * Title * Mr Ms Miss Mrs Address * City * State * Zip/Postcode * Date Of Birth * Gender * Male Female Prefer not to say Email * Home Phone Mobile Phone * Subscribe to our mailing list for news, special events and communication purposes. * Yes No Junior Players Are you a junior (Under 18) * Yes No School / Tertiary / Institution * Parent Mobile no. * Discount Code Membership Type Select Membership * Adult Membership $30Non-Player $15 Select Membership * Junior Membership $20Non-Player $15 Declaration & Consent Declaration I have read, understood, acknowledge and agree to the below declaration including the warning, exclusion of liability, release and indemnity. I acknowledge that if my application for membership is successful I will be entitled to all benefits, advantages, privileges and services of this membership. As a registered member of Sunshine Coast Beach Volleyball Inc. I undertake at all times to represent myself in a way that will not bring myself, my registered association, or the sport of volleyball as a whole into disrepute. I accept that failing to abide by this determination could lead to sanction by one or more of the aforementioned bodies. Insurance is in place that provides limited cover to you whilst you are performing or participating in any authorized or recognized SCBV activity. WARNING: Volleyball can be inherently dangerous. Serious accidents can and often do happen which may result in you being injured. I have voluntarily read and understood this warning and accept the inherent risks in Volleyball Players may at times be photographed. These photographs may be displayed on SCBV web pages and/or noticeboards. (Where applicant is under 18yo) I am the parent or guardian of the applicant. I expressly agree to be responsible for the applicant’s behavior and agree to personally accept the conditions set out in this membership application. Do you give SCBV consent to use images of you or your child for promotional purposes? * Yes No Today's Date Signature of member * Clear Parent Signature * Clear Payment Total Payment Method Paypal Credit Card Captcha Credit Card SUBMIT & PAY
