New Membership Application Salutations* Mr Mrs Ms Miss Name* Surname* Flat / Apartment Street Number* PO Box City* Name on Card* Date of Birth* DD slash MM slash YYYY Gender* Marital Status Occupation* CONTACT DETAILSTelephone Mobile* Email* I’m happy to receive emails from the Club about special deals, coming entertainment and Club promotions* Yes No Are you a member of another Affiliated Chartered Club?* Yes No If Yes, please list it here* Are you prohibited by Law from consuming Alcohol? ** Yes No Have you ever been refused or had membership revoked from any other Affiliated Club* Yes No Do you have any Criminal Convictions? (Other than driving offenses)* Yes No If yes - Please state Here* Membership Type & FeesMembership Type*Full Membership + Joining Fee ($40.00)Half Year Membership + Joining Fee ($30.00)Full Junior Membership + Joining Fee ($40.00)Half Junior Membership + Joining Fee ($30.00)Full Family Membership + Joining Fee ($70.00)Half Family Membership + Joining Fee ($45.00)Full Star Cricket Membership + Joining Fee ($40.00)Half Star Cricket Membership + Joining Fee ($30.00)Sporting & Special Interest Clubs 8 Ball or Pool Over 60's Pool TT&CC Golf TT&CC Indoor Bowls RSA Indoor Bowls St Josephs Indoor Bowls Karate Ladies Motorcycle Rod n Gun Mid Eastern Dance Cards / 500 Outdoor Bowls Hockey Petanque Go Carting Go Carting Family (3 or more) Pigeon Social Four Wheel Drive Darts Rock n Roll Star Cricket Social Star Cricket Senior Star Cricket Second Grade Star Cricket Under 20's Snooker Wine Friendship Membership photoMax. file size: 5 MB.upload photo belowPayment Method* Bank Deposit Pay online with by PayPal or with your Debit/Credit Card Total $ 0.00 Date* DD slash MM slash YYYY NameThis field is for validation purposes and should be left unchanged.