City of Sails Rock'n'Roll Revival Club @ www.cityofsails.org.nz

Membership Form

If you would like to print and post your membership application please click here.
If you would like to apply for membership online please continue below...

New Membership: Membership Renewal:

First Adult
First Name:
Surname:
D.O.B:
Postal Address:
Hm Phone:
Wk Phone:
Email:

Second Adult
First Name:
Surname:
D.O.B:
Postal Address:
Hm Phone:
Wk Phone:
Email:

Children (Please indicate here if more than two)

First Name:
Surname:
D.O.B:

First Name:
Surname:
D.O.B:

Please Select Membership Type:

Family:
Two adults plus children under 18 years of age (1 membership card, 1 newsletter)*	$40.00
Double:
Two adults, (1 membership card, 1 newsletter)*	$35.00
Single:
One adult (1 membership card, 1 newsletter)	$30.00
Junior:
One child or student 17 years or under (1 membership card, 1 newsletter)	$15.00

I would like to receive the club newsletter via:
Post**: Email:

** Please note that the newsletter will be sent to the address
under the ‘First Adult / Junior’ at the top of this form.

Please be aware that although this is an online form, we currently do not accept online payment. Payment will need to be discussed/organised when you are contacted by one of our comittee members.

All memberships are for 12 months from the date of joining and include the Adult $2.25 NZ Amateur Rock ‘n’ Roll Association Levy. By applying for membership you must agree to abide by the rules of this Club. Also, by ticking the box below (in lieu of your signature) and submitting your membership application, you agree / accept that all the information provided by you in this application is true and correct and that you will uphold the constitution of our club at all times.

As per our constitution, membership will not take effect until approved by vote of the Committee. To read, print or download a copy of the constitution please click here.