C/- Bp Express Brighton

C/- Bp Express Brighton

New Membership Subscription 2014/2015

Application for New membership for 2014/2015 season requires the completion of:

  1. Application for membership detail as per below.
  2. We will complete the Life Saving Online registration and annual update of SLSA Subscription information for each member on your behalf.
  3. Payment of Membership Annual Subscription.

Active Member

Membership entitlements are only available to financial members. This entitles you to participate in patrol, to use any club equipment and to compete in carnivals. This requirement is enforced to ensure that all members are covered by SLSA/LSV insurance.

Junior member under 15 years of age form part of a Family Membership

  • Each family member’sdetails are required to be updated on the SLSA Surfguard webto finalise registration.
  • Declaration form requires a parent or legal guardian to be signed.

Working With Children Check

  • All 18 year and over Members are required to provide a valid Working With Children Check (WWCC) registered with Brighton Life Saving Club Inc.
  • It should be noted that WWCC have an Expiry date of 5 years.

Schedule of Membership Annual Subscriptions
Membership Type / Membership Description / Code / Amount.
Associate / Person not holding a Life Saving Victoria Award, or a parent, guardian or spouse of a member (who cannot fulfil the duties of an active member) – subject to committee approval / A / $110.00
Active – Senior / Person 18 years and over at 30th September 2015 / AS / $90.00
Active – Junior / Person 15 to 17 years as at 30th September 2015 / AJ / $90.00
Family Subscription / Family membership includes dependents until they turn 18
“NB: all juniors under 15 years must be part of a family membership. No single nipper memberships” / F / $250.00
NIPPERS Annual Fee / Per Child registered in Nippers program
i.e. Family with 2 children in Nippers Program is a total of $310 / $30.00
  • Any member whose subscription is more than one month in arrears shall be liable, at the discretion ofthe committee, to forfeit his/her membership
  • Patrol requirements of Active members
  • 20 hours Patrol per season

Declaration
For the purpose of this Declaration, the word ‘Association’ will signify the Surf Life Saving Association of Australia Limited and its subsidiary companies and its affiliated State Centres, Branches and Clubs and other sub groups and members.
I hereby accept responsibility for my safety and personal possessions
I acknowledge and understand that activities of the Association may be dangerous in training, patrol activities, competition and rescue and I hereby attest and verify that I have no disabilities which may restrict my participation or ability to take part in Association activities in the membership category applied for.
I hereby consent to receive medical treatment which may be deemed advisable in the event of an injury, accident and/or illness whilst involved in Association activities.
I hereby agree to accept and abide by the respective Rules, Regulations and Resolutions of my Club and the Association.
I hereby represent the information given in this application form is true and correct to the best of my knowledge.
I tender the appropriate fees necessary for the consideration and acceptance of my Application for Membership.
I acknowledge and understand that acceptance of my Application for Membership does not guarantee acceptance into any course, program or event offered by my Club.
I accept the terms and conditions of the Declaration.
Signed---

Brighton Life Saving Club Inc

Established 1921 ABN 33 837 612 771

Mail: P.O. Box 7142 Brighton, Victoria. 3186

Phone: 9593 1591 Club

Mobile: 0409 104730 Club Secretary

E-mail

Club House Location: Foreshore opposite Keith Court Middle Brighton 3186

Application forMembership -Subscription 2014/2015 –Form

Detailof Member/s:

Member Names/Family Subscription–Please list all family members including under 15 years of age

/ Surfguardnumber
(If any) / WWCC proof number / Date of Birth / Amount
Surname / Given names
Optional board repair levy $20
Family Subscription
Registration in Nippers Program-$30 per child
Total Amount due / $

I hereby make application for membership of the Brighton Life Saving Club Inc.

If accepted I agree to conform to the Rules and By Laws of the Club

Applicants signature / Nominee Name / Nominee Signature / Application Date
/ /

PARENT/LEGAL GUARDIAN CONSENT (IN RESPECT TO AN APPLICANT 15 to 17 YEARS OF AGE)

I have agreed to the application of membership above and I personally consent to the application for Membership of the applicant.

SURNAME: ______GIVEN NAMES: ______
SIGNATURE: ______DATE: / /

Payment

Payment by credit card at lifesavingonline.com.au

  • Cheque payable to Brighton Life Saving Club Inc
  • Cash
  • Direct debit/bank transfer to: Brighton Life Saving Club
  • ANZ BANK
  • BSB 013 355
  • Account 86 13039
  • Credit Card

New Membership Application/Nomination:

  • Application for New members shall be duly nominated by two financial members of BLSC and nomination approved by the committee

Note Family Membership:“Detail of Member/s”requires details of all family members included in a family membership

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