ONLINE MEMBERSHIP FORM

Welcome to the new season!

Fill out the membership form below, or for a printable version CLICK HERE

Family Name
*Please make sure you add every individual of your families names below. Otherwise we can not add or update them in the SLSNZ database. Thank you.
First Name Date of Birth Membership Category
Postal Address
Email
Contact Numbers
Home Work Mobile
Fees
Membership Type Subs Competition Levy No. of Family Members per Category Total Due
Lifeguard - Patrolling & Competition $40.00 $30.00
Lifeguard - Family Maximum $120 $30.00 per competitor
Associate Member $20.00  
Junior Surf
(5-9yrs)
$20.00  
Junior Surf
(10-14yrs)
$20.00 $20.00
     
Total Due $
I will be paying by:

I consent to the collection of the above details by the Whakatane Surf Life Saving Club Inc. for its use and disclosure to the District and Surf Lifesaving New Zealand for the purpose of Club Membership and course enrolments. I understand that the information gathered will be used by SLSNZ for the NZ Database in order to implement effective administration systems and to provide general information to member and group statistical data finders, sponsors and media. This information is collected and held in accordance with the Privacy Act 1993. I acknowledge my right to access and correct this information under the Act.

I understand that I am responsible for the safety of my child while on the beach and will ensure that I as a parent of my child or an appointed guardian, will be on the beach at all times with my child. I understand that whilst the club will take all reasonable steps to ensure the safty of my child whilst at Surf Club Training the club is not responsible for my child's safety.

Club Policy Declaration: I declare that I/we agree to comply with the following policies that can be found HERE: Equipment Policy; Competition Policy; Administrative Policy; Complants Procedure Policy:

Your Name
Date
   
 

   
 

© Whakatane Surf Life Saving Club Inc. 2006
P. O. Box 2011, Whakatane 3159, New Zealand
Club Phone (07) 312 4676

WSLSC Administration Office
Phone (07) 307 2663 - Fax (07) 307 2664
email. whakatane@surf.org.nz