GERALDTON TENNIS CLUB

PO BOX 1481 GERALDTON WA 6531

Telephone 9921 2741 Fax 9965 3792

Email

MEMBERSHIP NOMINATION FORM

2016/2017 SEASON

PERSONAL DETAILS

Name……………………………………………………Email………………………………………………………………….

Address……………………………………………… Date of Birth………………………….Mobile……………………..

Emergency Contact Name and Number …………………………………………………………………………

MEMBERSHIP CATERGORY

Please select the membership (s) best suited to your needs. The list of Membership Categories and schedule of membership fees is listed on the reserve side of this form)

SENIOR FAMILY MIDWEEK STUDENT CONCESSION

JUNIOR DUAL CLUB MEMBER TWO FOR ONE MEMBER SOCIAL MEMBER

MEMBERSHIP FEES

Each membership fees includes GST and, Tennis West Affiliation and Personal Accident Insurance fees. The membership is from 1st July 2016 to 30th June 2017.

Amount: Membership Fee: $......

PRIVACY STATEMENT

I consent to the collection, storage, use and disclosure of my personal information in accordance with the tennis privacy statement and the tennis privacy policy, which contains information about how I may access and seek correction of my personal information, how I can complain about breach of my privacy and how the complaint will be dealt with.

I understand that I may receive communication regarding Tennis programs and activities from Tennis Australia

I understand that I may receive communication regarding Tennis programs and activities from Geraldton Tennis Club.

I consent to the use of images of me or my child (if under 18) being used on our Facebook Page, Newsletters, website or adverting material for the Geraldton Tennis Club.

Name of child if under 18……………………………………………………….

GERALDTON TENNIS CLUB MEMBERSHIP NOMINATION FORM

2016/20167SEASON

Contact Club Administrator on 0899212741 or email

Office hours Tuesday 9am to 12 noon.

MEMBERSHIP TYPE / MEMBERSHIP BENEFITS / FEE
Senior / Use of facilities at all times. Compete in Club
Championships / $200
Family / Use of facilities at all times. Compete in Club
Championships. 2 Adults – (Plus $45 per Child) / $360
(+ $45)
Midweek / Use of facilities Monday to Friday – not eligible to
Enter into Club Championships / $130
Student Concession / Use of facilities at all times. Compete in Club Championships. Must be attending tertiary
studies / $120
Junior / Use of facilities at all times. Once committee thinks Junior is ready to play with Seniors a letter will be sent in writing to the player. Must be 18 &
under / $55
Dual Club Membership / Use of facilities. Can not play in Club
Championship events. Must be member of another club, to be eligible for this membership / $120
Two for One Membership
(For first time members only) / Use of facilities at all times. This is for first time
Members to the club and is only available once. / $100
each
Social Member (Non Playing) / Use of Club Bar when open. Invitation to club
Social events / $20

Payment Options:

1.  Direct Credit into Geraldton Tennis Club account

Bank Details

633 000 146987896 (reference your name).

2. Payment via Cheque: Geraldton Tennis Club PO Box 1481 Geraldton WA 6531

New Member Authorised by:……………………………….Date:…………………………………