Membership / Renewal Form

This is a

New MembershipRenewal

Name

First NameLast Name

Address

Street Address

Postal Address if Different

Suburb / TownState

Post Code

Phone Number

Please enter a valid phone number. (Landlines start with 02)

Email

example@example.com

Child 1 (15 years or younger) - Name and Date of Birth

Child 2

Child 3

Child 4

Child 5

Type of Membership

JOINT MEMBERSHIP ($40) - 2 Adults includes their Children 15yrs & underSINGLE MEMBERSHIP ($20) - Single Adult (16 & over) includes their Children 15yrs & under

Do you hold a currrent Car Stand for the year 2021 Annual Show?

YesNo

Current Car Stand Number/s - COST / RENEWAL $20 each

Do you require your current Car Stand for the 2021 Show?

YesNo

If you are a Member and have not held a Car Stand in previous years and would like to be included on a waiting list, please indicate below. (Car Stands for recent and new Members are limited and will not be available for all those who require them).

Yes, put me on a waiting list.No thanks

RELEASE AND INDEMNITY AGREEMENT

In exchange for being allowed to enter the showground with a motor vehicle I hereby agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS THAT I MAY HAVE AGAINST THE Gloucester AH&P Association Inc, its officers, employees, agents and representatives.

2. TO RELEASE the Gloucester AH&P Association Inc from any and all liability for any loss, damage, injury or expense that I, or my next of kin, may suffer or incur as a result of my actions due to any cause whatsoever.

3. TO HOLD HARMLESS AND INDEMNIFY the Gloucester AH&P Association Inc from any and all liability for property damage, personal injury or death suffered by myself or by a third party as a result of (a) my use of the facilities and/or (b) my breach of the terms and conditions upon.

4. THAT THIS RELEASE AND INDEMNITY AGREEMENT shall be effective and binding upon my heirs, next of kin, executors, administrators, and assigns in the event of my death.

5. TO OBEY all warning signs and other notices posted within the facilities.

6. To carefully follow all instructions given by the Gloucester AH&P Association Inc, its officers, employees, agents and representatives.

7. TO NOT drive any vehicle within the show grounds whilst under the influence of alcohol or drugs prohibited by law.

I have read and understood the Release and Indemnity Agreement as listed above prior to signing and am aware that by signing this document, I am affecting the legal rights and liabilities of myself, my heirs, next of kin, executors, administrators and assigns. the Gloucester A.H.&P. Association Inc. Signature:-

or Tick to Agree

I agree

Date