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Contact Us
About Us
Membership
Community
Central Board of Directors
Life Members
Vision & Values
Club History
FAQ
What’s On
Dining
Reservations
Book a Table
Functions
Boardroom Bookings
Functions Booking
Contact Us
MEMBERSHIP RENEWAL
ALL FIELDS OF THE FORM MUST BE COMPLETED FOR VALID MEMBERSHIP
All fields marked with (*) are required.
Membership Number
*
Name Title
*
MR
MRS
MISS
MS
Given Name/s
*
Surname
*
Full Address
*
Suburb
*
State
*
Postcode
*
Postal Address If Different From Above
Suburb
State
Postcode
Phone No. Home
*
Date of Birth
*
DD slash MM slash YYYY
Mobile (04)
*
Email
*
Occupation
*
Offers and Promotions
I Do Not Wish To Receive Information From Central About Its Offers & Promotions
Are You A Member Of Any Of The Below:
Central Seniors RLFC
Central Juniors RLFC
Central Netball
C/Town Netball Assc
Bingo
Central Cricket Club
Kahibah FC
Leggy Point BR
Jazz Club
Central Summer Touch
Central Social Golf
Dudley Redhead RLFC
NDCUA
Probus Club
I WOULD LIKE TO APPLY FOR A:
*
1 YEAR ($9.00)
3 YEARS ($14.00)
5 YEARS ($17.00)
7 YEARS ($19.00) BEST VALUE
I WOULD LIKE TO OPT OUT OF MY REWARDS
Total
$0.00
I HEREBY CERTIFY THAT I AM OVER THE AGE OF 18 YEARS.
I ACCEPT THE NOMINATION HERE UNDER AND AGREE IF ELECTED TO MEMBERSHIP TO BE BOUND BY MEMORANDUM AND ARTICLES OF ASSOCIATION AND ANY RULES, REGULATIONS OR BY-LAWS OF THE CLUB FROM TIME TO TIME IN FORCE.
Membership Payment
Comments
This field is for validation purposes and should be left unchanged.