KMBC Membership Application Form
Personal Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000-000-000.
Date of Birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Occupation
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Emergency Contact Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: 0000-000-000.
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Next
Membership Information
Type of Membership
*
Junior Membership
Full Membership
Social Membership
Are you a current member of another bowls club?
*
YES
NO
Name of current Bowls Club
*
Are you a previous member of another bowls club?
*
YES
NO
Name of previous Bowls Club
*
Have you fulfilled all financial obligations to current or previous bowls clubs?
*
YES
NO
If yes, clearance should be produced to the club ASAP.
Bowls Qualifications held?
Coach
Umpire
Have you in Queensland or elsewhere been suspended, expelled or refused admission to any Bowls Clubs?
*
YES
NO
If yes, further information required: please state the name and address of any such clubs.
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Privacy and Acceptance
I give permission for the club to publish my name and phone number in the club directory.
*
YES
NO
I consent to photographs and/or videos of myself, or my child (where applying for junior membership), being taken and used by the club for promotional and communication purposes, including on the club's website, social media channels and other club materials.
*
YES
NO
If elected to membership, I agree to comply with and be bound by the Rules of Association and By Laws of the club.
*
YES
NO
I understand that by submitting this form I am applying for membership at Kallangur Memorial Bowls Club for myself or on behalf of my child. I agree to be contacted by KMBC to finalise membership processes.
*
YES
Submit
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