Club Membership Registration Form

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Name
First Name
Last Name
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E-mail
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Phone Number
4
Address
Street Address
Street Address Line 2
Suburb
State
Postal Code
Please Select
Please Select
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Armenia
Aruba
Australia
Austria
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The Bahamas
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Brazil
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China
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Colombia
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Cuba
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Cyprus
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Democratic Republic of the Congo
Denmark
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Dominica
Dominican Republic
Ecuador
Egypt
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Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
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Greece
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Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Kenya
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Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
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Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
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Sudan
Suriname
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
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Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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* This field is required.Intertrek Pty Ltd (Australian distributor for La Sportiva) is committed to safeguarding personal privacy. Unless given consent to do otherwise, Intertrek will only collect and use personal information as set out below. When you sign up for a competition or membership personal information may be requested (such as name, address, email, phone numbers) to advise you of other related products competitions which may be of interest. We will not reveal your personal information to any external organization. Personal Information will be used for the following purposes: To provide you with information about products, services and/or special offers. To obtain opinions or comments about products and/or services. To record statistical data for marketing analysis. Intertrek recognises the trust with which individuals provide personal information, and such information will not be used or disclosed for any other purposes than those given above without your consent, except in exceptional cases when disclosure may be required by law or is necessary to protect the rights or property of Intertrek, or any member of the public. Email newsletters: If you opt in to receive the La Sportiva newsletter we will send you an occasional newsletter with information that we hope you will find of interest. You may opt out of this at any time by using the unsubscribe link in every email. Intertrek may contact individuals using the information which was provided by them in order to: Provide information about new products, special offers and other matters relating to your purchase that may be of interest. To send newsletters about outdoor equipment, tips or information about outdoor equipment, or related matters. If an individual receives communications from Intertrek which they do not wish to receive, they may remove their name from our contact database by clicking on the "unsubscribe" link which is in every communication. This will automatically unsubscribe and this is effective immediately. Intertrek will endeavour to take all reasonable steps to keep secure any personal information recorded, and to keep this information accurate and up to date. The information is stored on secure servers if in digital format, or in locked areas if in hard copy format. Intertrek employees are obliged to respect the confidentiality of any personal information held by Intertrek. However, security of communications over the Internet cannot be guaranteed, and therefore absolute assurance that information will be secure at all times cannot be given. Intertrek will not be held responsible for events arising from unauthorised access to personal information. Intertrek provides links to web sites outside of the Intertrek site. These linked sites are not under the control of Intertrek, and Intertrek is not responsible for the conduct of companies linked to the Intertrek website. Inquiries relating to our Privacy Policy, or any problems or complaints maybe directed to the General Manager by calling us at 02 9417 5755.
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