MEMBERSHIP FORM
2021 – 2022
NAME*:_______________________________
POSTAL ADDRESS*:____________________
SUBURB*: ____________________________
POSTCODE*:__________________________
DATE OF BIRTH: __ /___ /______
SAIL NO. __________
SEX*: MALE / FEMALE
PROPOSED SAIL NO.
OPTION 1: ___________ OPTION 2: ____________ OPTION 3:____________
EMAIL*:__________________________________________
PHONE* (H):(03)_____________ (W): (03)_____________ (M):_______________
MEMBERSHIP * --- 1 July 2021 to 30 June 2022
Membership includes: access to competitions in Victoria & nationally, public liability insurance during organised events via AWA, sail number registration and much more! Refer to AWA website for more details on the sports insurance policy www.windsurfing.org/insurance.
Please note; WV membership fees help to cover WV ongoing yearly costs (e.g. AWA insurance, equipment for the Teach a Mate extended program, events, trophies, marketing, etc).
Membership Options:
- Standard $45
- Pensioner or Full-Time Student (up to 25 years of age) $25
- Windsurfer Class Association Australia (+35)
- Names of Additional Family Members @ $25 each
WV Volunteer*
Would be able to help out as WV Volunteer at a WV event during the season? Yes / No
PAYMENT (Please mark one) *
- EFT – PayPal (Visa/MC)
- Cash
- Cheque
EFT Commonwealth Bank Acc Name Windsurfing Victoria BSB 063550 Acc no. 10236618
PayPal Payments can be made via the Windsurfing Victoria website on the membership page.
Select the type of membership and follow the PayPal cart buttons.
Credit Card If PayPal cannot be made, please complete the following to authorise Windsurfing Victoria to complete the payment for you.
NAME ON CARD INITIAILS:_________________________
CARD NO. EXPIRY DATE:____________________________
SECURITY CODE (last 3 numbers on signature strip):___________________
AMOUNT: $_________
SIGNATURE * ____________________________
DATE *___/____/______
PARENT?S SIGNATURE (if under 18):____________________
Send to: WINDSURFING VICTORIA
Mail: 221 Esplande West, Port Melnbourne, Vic 3207
See website for WV Privacy Policy
Windsurfing Victoria Inc. ---- Reg No. A0049214P ABN 59 441 540 713