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Are you 17+ yrs?

Yes
No

Name*

First Last

Gender*

Male
Female

Date of Birth*

Address*

Street Address Address Line 2 City ZIP / Postal Code

Contact Number

Mobile Number*

Email*

Purpose of Membership*

Sports
Cultural
Club Supporter

Are there any medical conditions we should be aware of? (Complete if Yes)

Where did you hear about us?

eg. Friend, Facebook, Member, News

Under 17 Members

This Section is for Members Under 17 Only (Parent/ Guardian to fill)

Parent/Guardian Name

First Last

Relationship to Member

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone Number

Club Membership Rules*

I have read, understood, and accept the rules for membership

- Club Information will be emailed or sent via SMS to you from time to time
- I agree to abide by the Rules, Regulations & Codes of Conduct as set down by Saanjh Sports & Cultural Club Inc.
- I give permission for my child's photo(s) in a team or individual situation to be published on Saanjh Sports & Cultural Club website, social media or in the news.
- I confirm that my details as set out in this membership form are true and correct. If my details change during the year i will advise the Saanjh team so it can be updated.
- I understand that Saanjh Sports & Cultural Club will have a club fee which will be an annual fee for my membership.

Privacy Statement*

I have read, understood, and accept the privacy statement

Your personal information is being collected by SAANJH SPORTS AND CULTURAL CLUB INC.

Saanjh may work with other providers to administer our membership database and the delivery of services to Members, but if we do so we will inform you and take steps to ensure all information is held securely.

Saanjh is collecting your personal information for the purposes of:

• administering your membership;
• maintaining a database of Saanjh members (past and present);
• complying with the Incorporated Societies Act 1908;
• providing you with information about Saanjh events and activities; and Sending you the Saanjh newsletter, function invitations, membership renewal notices, and other information Saanjh considers relevant to you.

Print Full Name

First Last

Newsletter

Yes, sign me up!

Membership Payment

Each membership is $50 per person, this is an annual fee. Please make your payment directly to our bank account, please ensure you are making separate payments for each individual.
Saanjh Sports & Cultural Club Incorporated
12-3083-0720145-00
Reference - Member Name
Particulars - Purpose of Membership. eg. Sports , Cultural, Club Supporter

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