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NEW MEMBERSHIP AND RENEWAL APPLICATION
I wish to apply for New Membership/Renewal of membership for the 2010/11 competition season. I agree to abide by the Gold Coast Malibu Clubs rules and regulations and by any lawful requests from the clubs office bearers. I am aware that I am under no obligation to enter the surf and may withdraw from the event at any time if I consider the conditions or the location unsuitable or dangerous and in any case I take full responsibility for my own safety and indemnify the organizers, committee and club from any liability that may be incurred with regards to my participation in these events.
Name
Address
Phone Home Mobile
Date of Birth
Signed (Parent or Guardian to sign if under 18 years )
Type of membership Ordinary $40 Jnr $20 Life $20 Family $80
Please return with your membership application and appropriate payment to THE TREASURER, Gold Coast Malibu Club Inc PO Box 966 Coolangatta Qld 4225 Or pay by direct deposit into bsb 062611 acc 10017319 and email your membership application and copy of the receipt to treasurer@goldcoastmalibuclub.com.au
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