Membership No. *  
First Name *  
Last Name *  
Date of Birth *
Contact No. *    
Email *   
Purchase receipt will be emailed to you
Residential Address *  
Suburb *    
Postal Code *    
State *
Postal Address
Postal Code  

     all fees listed include GST
Should we mail your card to you or hold it at the club for collection?
Please note: Payment for renewals are processed within 2 working days of submitting this form. If we are holding the card at the club for collection, please allow 2 working days for the card to be available for pickup. Alternatively, if we are posting the membership card, please allow 2 working days plus additional time for postage. If your renewal is urgent, please phone reception on 8868 9200 or visit club reception for immediate processing.
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Credit Card No.
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