Club Membership Registration Form

Address:

Birth Date

Day Month Year Date Picker Icon
Phone Number

Area Code Phone Number
Mobile no
Membership type *

Junior $ 45 Any person between 7 & 16 in the year of application Tertiary $ 45 Any person in full time tertiary education (proof required) Senior $ 75 Any person over the age of 16 not at school Family $ 150 One or both spouses and their children who comply to junior cat Married $ 130 Adult couple at the same address
Family member 1

First Name Last Name
Birth Date 1

Day Month Year Date Picker Icon
Family member 2

First Name Last name
Birth Date 2

Day Month Year Date Picker Icon
Family member 3

First Name Last Name
Birth Date 3

Day Month Year Date Picker Icon
Family member 4

First Name Last Name
Birth Date 4

Day Month Year Date Picker Icon
Family member 5

First Name Last Name
Birth Date 5

Day Month Year Date Picker Icon
If you are joining for the first time or rejoining after a period away from the club please remember to include $ 25 (re)application fee in addition to the subscription fee
Were you a member of the club last year ? *

Yes No
Joining fee
Amount to pay
Payment type

Cheque payable to "Otago Ski Club", PO Box 995, Dunedin NZ Online banking (ref "subs" your surname & initial) 06-0901-0026574-00
Membership fee
Renewaldate
Where did you hear about us?

A Friend or colleauge Google Facebook Advert
Please select the mountain activity you are joining for

Skiing/bording Hang gliding/paragliding Mountain biking Other
Please describe your activity
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