New Membership Application 1 April 2010 to 31 March 2011
NAME: _______________________________________________________
ADDRESS: ____________________________________________________________
_______________________________________________________________
Email address_________________________________________
PH: Cell: ________________ Hm: __________________ Wk: ____________________
Date of Birth (If under 17): _________________ Age: _________________
FAMILY MEMBERSHIP: (husband and/or wife/Partner plus Dependant Children. Please include details of all nominated members. Only those nominated are included in the Membership)
NAME: ____________________ AGE: _____
NAME: ____________________ AGE: _____
NAME: ____________________ AGE: _____
NAME: _____________________ AGE: ____
BACKGROUND:
Archery Experience _________ years. With F.C.A ___________ years.
Are you or any of the Family Membership a current Financial Member of another Target or Field Archery Club? Yes/No If so, which? _________________________________
TYPE OF EQUIPMENT: please circle appropriate
Compound Recurve Longbow Yet to acquire
MEMBERSHIP SUBSCRIPTION AND JOINING FEES:
Concession Card: $165.00 This entitles the holder to shoot at Outdoors for 12 months without paying shooting fees each time. This doesn’t include any Tournaments or Special Club Shoots
Senior: $55.00
Junior: $27.50 16 yrs and under
Family: $110.00
Veteran: $40.00 55 yrs and over
Payment Enclosed: $____________________________________
I, and on behalf of the nominated members of my family, consent to Franklin County Archers collecting the details provided in the above Membership Application, retaining, using those details and disclosing them for the purpose of involving the above said persons in the Franklin County Archers activities now and in the future and to also disclose the same details to a third party directly affiliated to Franklin County Archers. This consent is given in accordance with the Privacy Act 1993.
I and on behalf of nominated members of my family, agree to abide by the Constitution and Rules of Franklin County Archers.
Signed: ____________________________ Date: _____________________
Membership will not be confirmed until approval of the Committee, upon which receipt will be issued
