West Brunswick Tennis Club

ABN 61 053 986 944

Membership 1 July 16 – 30 June 17

New Member Once only joining fee $40 per individual or $80 per family $A

Late Renewal fee$30 for renewals paid after 30 September $A

Membership Type

Junior $105 Concessional$140

Adult$165 Family $330 $B

Note: Pro-rata fees are available for New Memberships. These are applied automatically if joining online, or please contact the club via for the amount due.

Junior Being less then 18 years of age as at 1 July of renewal year

Concessional Being 18 years of age and under age 25 and being a full-time student, or being a person in receipt of a current Pensioner Heath Care Card or a Low Income Health Care Card. Proof of eligibility is required.

FamilyParents/Guardians or two “partnered” adults including dependent Junior and Student concessional members

Primary Applicant Details

Surname / First Name / Gender (M/F)
Mobile  / Home  / Date of Birth
Residential Address
Postal Address
(if different)

Details of others included in this membership

Surname / First Name / D.O.B / Gender / Email and mobile phone (if over 15)

Total payable: (A+B)$

Direct Debit: BendigoBank BSB 633-000 Account 1464 83979

Please include your name as a reference

Cheque or Money Order: Make payable to “West Brunswick Tennis Club Inc”

Please include the name of the member on the back of the cheque

Tennis Victoria Declaration

Your membership will be registered in the Tennis Australia My Tennis database. The terms and conditions can be found at

and on a noticeboard in the clubrooms.

I acknowledge the My Tennis Terms and Conditions:

Privacy Policy: Tennis Victoria requires the information requested on this form to provide you with membership benefits, to receive timely and relevant information and communications related to tennis and for related purposes which can be reasonably expected. In addition, we may use your personal information to advise you of promotions, events, special offers and other like activities offered by Tennis Victoria or its stakeholders. You are able to access your personal information through Tennis Victoria upon reasonable notice. Except where permitted or required by law, or where your consent is obtained, this information will not be disclosed to third parties.

I acknowledge the Tennis Victoria Privacy Policy:

As part of being a tennis member, it is expected that you will receive tennis specific communications from time to time from your club, state body and/or national body.

You do however have the option to opt out of marketing related communications.

I do not wish to receive marketing related communications.

Completed membership forms can be returned via email to

or post to PO Box 72, West Brunswick 3055