2021 VIP MEMBERSHIP FORM

APPLICANT INFORMATION

Full Name *

First Name Middle Name Last Name

Address *

Street Address

City State

Post Code

Date of Birth *

Date

Contact Details *

Phone Number Email

Preferred Membership Number 1-100 (Optional)

Please upload image or scanned copy of a Government issued form of Identification (Passport, Drivers' License or Proof of Age card etc) *

MAGNET HOUSE VALUES & MEMBERS RULES

Click HERE to download and read the Magnet House Values and Standards.

Clink HERE to download and read the Magnet House Membership Rules.

Please confirm the following; *

I have read and understand the Magnet House Values and Standards I have read and understand the Magnet House Membership Rules 2021 I do not have an existing Scantek ban and/or am allowed to attend licensed premises I will be ultra-inclusive of all sexes, genders and race and I will celebrate diversity I understand that as a potential VIP Member of Magnet House, Security and staff can restrict entry in accordance with the Liquor Control Act (1988)

PAYMENT DETAILS

CONFIRM MEMBERSHIP *

Magnet House 2021 VIP Membership As a member you and 3 guests will jump straight to the front of the VIP line with free entry on all regular operating nights (Exclusions apply, ie. restrictions relating to the Liquor Control Act (1988), special events, private events. - Free cloaking for you and your guests (2 fabulous items per person per night). - Magnet House will endeavour to negotiate with all third parties to provide VIP access to special events where possible. Benefits may include VVIP entry for Members with purchased tickets, discount tickets or early access. - Magnet House will also offer monthly VVIP specials and offers! This may include discounted booth packages, bottle service or value added tray of shooters.

$ 1,000.00 AUD Quantity

Total

$ 0.00 AUD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

The above credit card details will be used as an authorisation ONLY. A member of the Magnet House team will be in contact with you before charges are applied to your card.

DISCLAIMER & SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application is successful, I understand that false or misleading information in my application may result in my removal from the Membership.

Signature *

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Date *