PLEASE
RETURN FORM TO:
The
OZFIN Treasurer
Mr
Glen Hoppitt
NEW/RENEWED OZFIN/AUF MEMBERSHIP FORM
Name
.
Club
...
Mailing
Address:
..........
State:
..Post
code:
Date of Birth / /
Phone:
(
)
. Home (
)
..Work
(Mob)
Fax: (
)
Email:
Occupation:
..
Australian
Citizen? Y / N Nationality if not
Australian
Gender M / F
(NOTE: members
must be an Australian citizen to claim records or gain selection on an
Australian team)
SCUBA
QUALIFICATIONS:
CERTIFICATE NO
..
CURRENT
SPORTING QUALIFICATIONS: (e.g. Official, Coach, Pool Lifeguard, First Aid,
other)
..
...
CONDITIONS OF MEMBERSHIP AND WAIVER
I
.
acknowledge that Fin Swimming can be a dangerous
sport and agree to participate at my own risk.
I also
acknowledge that I am responsible for my own health and safety and hereby
absolve the OZFIN executive,
and executive members of affiliated clubs
from any financial responsibility or compensation that may arise from my
participation.
I further agree to inform coaches and club officials of any illness that
may prevent me participating
in training or competition and absolve
them from all responsibility. I agree to
abide by the ru
OZFIN MEMBERSHIP:
Competitor $ 50
(includes AUF fee)
or Non-Competitor $
40
State/Club Levy $
TOTAL $
Please find
enclosed cheque/money order to the value of $
signature
.
Date
./
../
.
(this signature designates agreement for the above conditions
of membership and should be signed by the applying member
and in the case of a
junior, a parent or guardian should also sign). Unsigned applications will void insurance.
FOR OFFICIAL USE ONLY:
Club
Received / /
OZFIN
Received /
/
AUF Received
/ /
Membership number