New Membership Application 2026/2027

Berry Springs Recreation Reserve Inc.

130 Cox Peninsula Road, Berry Springs NT 0838 www.bsrr.com.au berryspringsrecreationreserve@outlook.com
Membership Application 2026/2027

Applications April 2026 - June 2027

Application For Membership in Accordance to Clause 9
I (insert Full Name)*

First NameLast Name
Of (insert Residential Address)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
And (insert Postal Address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Number 1 (Mobile)*
Please enter a valid phone number.Format: (000) 000-0000.
Contact Number 2 (landline)
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Hereby apply for Membership of the Berry Springs Recreation Reserve Inc.

I declare that I am over the age of 18 years old.

User Code of Conduct can be found on our website www.bsrr.com.au
Signature*
Date*

MonthDayYear
Date

My Products

Berry Springs Recreation Reserve Inc - Membership 2024/2025

This Membership will expire 30th June 2025

$5.00AUD Quantity

Total

$0.00AUD

Your membership will be sent to the Berry Springs Recreation Reserve Management Committee for approval. We thank you for becoming a member of the reserve. Confirmation of membership together with relevant information will be emailed to you once your membership is finalised.

If you have any questions, please contact us at berryspringsrecreationreserve@outlook.com
ADDITIONAL:

If you have a financial proposer and seconder, please insert their information below.

We, the undersigned, declare that we are members of the Berry Springs Recreation Reserve Inc.
Proposer

First NameLast Name
Signature
Date

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Seconder

First NameLast Name
Signature
Date

MonthDayYear
Date
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
FOR OFFICE USE ONLY
Application Accepted / Rejected

AcceptedRejected
If rejected, state the reason why
Date Letter Sent

MonthDayYear
Date
Should be Empty: