Membership Application Form – Manly Diggers Swimming Club

Please fill out all relevant sections then print this page and either bring it with you to our Sunday swim or scan and email it to info@manlydiggers.com.au

Membership Type*

Name*

First Last

Address*

Street Address Suburb State Postcode Country

Date of Birth*

Email

Mobile phone

Home phone

I hereby make application to join Manly Diggers Swimming Club as a Full Active Member.

If Accepted I agree to pay the entrance fee of $10 together with the Annual Subscription of $20 immediately. I further agree to abide by and conform to the existing Constitution and Rules of the Club including any amendments during the period of my membership.

I have been attested of Her Majesty's Forces having served in

Service Name

My Discharge Number Is

I am eligible to be a Member of Returned and Services League of Australia

Yes
No

I am prepared to take an active part in the Club's Swimming events as*

a competitor
a racing official
both - I'm happy to help out if required

I hereby give permission for any photos taken of myself, in the course of swimming club activities, to be published on the Manly Diggers Swimming Club web and Facebook sites.*

Yes
No

Signed By

Date Signed

Payment method

Internet transfer / direct deposit
cash
cheque

Total Payable

$ 0.00

Medical and Health Information

For medical reasons only, please indicate if you have a known medical condition, allergy or disability, e.g. asthma, epilepsy, diabetes or bee sting allergy, sight or hearing impairment.

Emergency Contact Details*

Name, Relationship, Contact phone number(s)

Proposed By

Seconded By

Accepted

Secretary

Application for Membership