Lake Jindabyne Sailing Club

First Name

Surname

Select one -

Female
Male

Email address

Phone Number (Mobile preferred)

Address (include postcode)

Date of Birth (ddmmyyyy)

Emergency Contact Name

Emergency Contact number

Boat Name

Boat Class

Sail Number

Do you have a boat license?

Yes
No

Do you have a First Aid Certificate?

Yes
No

The next bit is REALLY IMPORTANT. Please make ONE SELECTION.

I hereby apply for membership of the Lake Jindabyne Sailing Club Incorporated. In the event of my admission as a member, I agree to be bound by the Rules of the Association.

Adult Membership ($130)
Junior Membership - U18 @ 31/12/23 ($50)
Social Membership ($60)
Student Membership - 18 to 23 @31/12/23 ($50)
Junior Membership - U18 @ 31/12/23 ($50)

Thank you for submitting your application for membership of the Lake Jindabyne Sailing Club. You will receive an invoice for your membership fee via email in the next day or so.

______________________________________________________________________________________________

OFFICE USE ONLY

Application APPROVED / DECLINED on ________________ by ____________________