| Mr / Mrs / Ms / Miss:____________________________________________________
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| Surname:_______________________________________________________________ |
| Given Name:____________________________________________________________
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Address:_______________________________________________________________
_______________________________________________________________________
_____________________________________Post Code:________________________ |
| Birthdate: D(_____) M(_____) Y(_________)______________________________
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Telephone
Numbers: |
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Home: (___)_______________________________________________
Business: (___)_____________________________________________ |
| E-Mail Address:___________________________________________________________ |
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| Occupation:_____________________________________________________________
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I wish to apply for membership of KuRingGai Bowmen Inc. implying
affiliation with the Archery Society of New South Wales and Archery
Australia. I have previously undertaken and completed a beginners
course at this club:
Club Name:__________________________Date:_______________________________
I understand and agree to abide by the rules of the association.
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| Signed:_________________________________________________________________
Date:___________________________________________________________________
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| If the applicant is a junior (ie. under 18 years of age) we require
a Parent or Guardians authorisation:
Parent/Guardian's Name:_________________________________________________
Signature:_____________________________________________________________
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| Note: If the applicant is under 12 years of age we require
a Parent or Guardian to be in attendance at all times.
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Optional and confidential: To help us to prepare for any possible
medical emergency, do you have a medical condition that you feel
we should know about or that may or may not affect your physical
abilities:
_______________________________________________________________________
_______________________________________________________________________
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