Squash Bucklers – Interim Membership Application

Squash Bucklers – Interim Membership Application

This interim membership form applies during the club’s establishment phase.
Full Name*

First NameLast Name
Preferred Name (if different)
Email Address*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact Name*

First NameLast Name
Relationship
Emergency Contact Phone Number*

Area CodePhone Number
Membership Type (Once we are fully established)*

AnnualMonthlyCasualAffiliateNon Playing
Note: Membership categories, fees, and voting rights will be formally confirmed and adopted at the Club’s first general meeting.
Interim Fees & Payments

During the interim period:
- Courts will be booked by the Founder or a nominated committee member.
- Members agree to reimburse their share of court hire or agreed costs.
- No long-term membership fees are being charged at this stage.
Do you agree with the Interim Fees & Payments conditions?*

I understand and agree to the interim payment arrangement described above.
Health & Safety Acknowledgement

Squash is a physical sport with inherent risks, including the risk of injury.

By joining Squash Bucklers, I acknowledge that:
- I participate voluntarily and at my own risk
- I am responsible for my own health and wellbeing
- I understand that wearing appropriate protective equipment (including eye protection) is strongly recommended
Nothing in this agreement limits the application of New Zealand law, including the Accident Compensation Act (ACC)
Do you agree with the Health & Safety statement?*

I acknowledge and accept these risks.
Code of Conduct & Club Policies

I confirm that I:
- support the inclusive, rainbow-friendly values of Squash Bucklers
- agree to abide by the Club’s Code of Conduct
- agree to follow any safety guidelines or policies set by the Club
- understand that serious or repeated breaches may result in suspension or termination of membership
Do you agree with the Code Of Conduct policy?*

I agree to the Code of Conduct and Club policies.
Interim Status Acknowledgement
I understand that:
- Squash Bucklers is in an establishment phase
- This is an interim membership arrangement
- Final membership fees, structures, and procedures will be agreed at the Club’s first general meeting
- I will be notified of, and may participate in, that meeting in accordance with my membership type
Do you agree with the Interim Status Acknowledgement?*

I acknowledge and agree.
Declaration
I confirm that the information provided is accurate and that I wish to join Squash Bucklers under the interim arrangements described above.
Signature*

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