Renewal Form

LRYC Membership Renewal
Your details

NOTE: Existing club members are asked to re-enter their details so that we can update any changes.
Name*

First NameLast Name
E-mail*
Your preferred email address
Home phone and/or
Mobile phone
Home Address*

Street Address

Street Address Line 2

Suburb/TownState

Postcode

Emergency contacts

Please indicate one or two emergency contact persons with their phone numbers.
Contact/emerg. 1*

NamePhone Number
Contact/emerg. 2

NamePhone Number
Membership Requested*

FullPensionerJuniorFamily
Family Membership indicate all other Family names here
Primary Club

Fees and payment details
LRYC Inc Membership Types:
- Single - $50.00
- Pensioner - $40.00
- Family - $80.00
- Junior (U/16) - $25.00
Family membership is based on 2 Adults and 2 Juniors (U/16) in the one family

Direct Deposit fees to Bendigo Bank:

Account Name: Lilydale Radio Yacht Club Inc

BSB 633 108 Account No: 146 303 383

In the reference field: Please put your name.

When you have paid membership please email Benson Or (Treasurer) at treasurer@lryc.org.au to indicate that the money has been transferred to us.

THANK YOU
For the purposes of our Club Communications, I give permission to allow LRYC Inc to send me Newsletters, Bulletins and any other Club Information to my email address.

Please note that LRYC Inc will not divulge your personal information to anyone.

By selecting the submit button below you agree to the above terms.
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LRYC Membership Renewal