Your Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

MM

DD

YYYY

Next of Kin Name

First Name

Last Name

Next of Kin Phone

(###)

###

####

Membership Catergory *

Full Bowls Member ($150)

Associate Member ($60)

Junior Member ($25)

Are you or have you been a member of a Bowling Club? *

Yes

No

Do you hold any bowling qualifications, such as umpire or coach

Yes

No

Terms and Conditions ( only applicable to Full and Associate Members) *

I hereby make application to become a member of Camp Hill Community and Sporting Club Incorporated, and hereby lodge the requisite nomination fee ($20). In the event of my being elected, I agree and will be bound by the Constitution, Rules and By-Laws of the Club.

I agree

I do not agree

Not applicable