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To create a PDF and print this form click on the PDF logo at the top of this page. Counties Sun Club
112 Ramarama Road, RD3 Drury Auckland 2579, (027) 296 2795
Membership Application Form (full) Full Name 1:_________________________________________DOB:_____________
Occupation:______________________________________________ Full Name 2:________________________________________ DOB:_____________
Occupation:______________________________________________ Childs Name______________________________________ DOB:_____________ Childs Name________________________________________ DOB: ____________ Residential Address:_________________________________________________________ Postal Address:_____________________________________________________________ Email Address:______________________________________________________________ Phone Number:_______________________Mobile Number:_____________________
If you have held or hold Membership with any other INF, ANF or NZNF affiliated club, please give details of membership etc. Do you have any skills/interests, which you may wish to share with the Club? ____________________________________________________________________________ Supply of and acceptance of this form does not guarantee acceptance of Membership.
Membership can only be approved by the Management Committee
Subscriptions will be payable on notification of acceptance of Membership which will become effective on such payment.
If accepted as members I/We agree to abide by the rules and bylaws set by the Club and to uphold the confidentiality of other members (Privacy Act 1993)
I/We understand that failure to comply with thee requirements may result in suspension or termination of membership from the Club.
The Club accepts no responsibility for accidents or injuries that may happen on the Club Grounds. .
Sig 1:__________________Sig 2:_______________________ Date: ___________ _______________________________________________________________________________________________
Counties Sun Club administration only: Accepted/Rejected: ___________________________ Date: ____________________ Membership Sec: _______________________President ______________________
post to: 112 Ramarama Road, RD3 Drury Auckland 2579
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