Victorian Curling Association Membership Registration Form 2019

Full Season (16 weeks) including Membership - Adult $450 Full Season (16 weeks) including Membership - Junior/Wheelchair $250 Half Season (8 weeks*) Green League (School Term 2) including Memb. - Adult $275 Half Season (8 weeks) Gold League (School Term 3) including Memb. - Adult $275 Half Season (8 weeks*) Green League (School Term 2) including Memb. - Junior/Wheelchair $150 Half Season (8 weeks) Gold League (School Term 3) including Memb. - Junior/Wheelchair $150 Membership only - Adult $50 Membership only - Junior/Wheelchair $30

Members, team name, season

Learn to Curl Program (4 weeks) including Membership - Adult $100 Learn to Curl Program (4 weeks) including Membership - Junior $60 Learn to Curl Program (4 weeks) (already Member) - Adult $50 Learn to Curl Program (4 weeks) (already Member) - Junior $30

See link: http://www.curlingvictoria.org.au/calendar

Date

First Name Last Name

Date

Street Address
Street Address Line 2
City	State
Postcode	Country

I am of Aboriginal / Torres Strait Islander origin I have a current Working With Children card I DO NOT wish these details to be included on a membership register to be distributed to all members.

Returning league curler Beginners comp participant Come and Try participant Learn to Curl participant Google Facebook Other

First Name Last Name

Street Address
Street Address Line 2
City	State
Postcode	Country

Victorian Curling Association Membership and Registration Form 2019

Payment Details

Applicant Details

Emergency Contact

Declaration