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ADDRESS INFO
Membership Type *	Adult Family (free) A member of the Nominated Family member, grouped by Family name. Junior Family (Under 18) (free) A junior member of the Nominated Family, grouped by Family Name New Student (Under 25 - includes joining fee & swipe card) ($110.00) Student (Under 25) 2011/2012 ($70.00) Full Adult 2011/2012 ($130.00) Full Adult Membership New Full Adult (Includes joining fee & swipe card) ($220.00) New Nominated Family (Includes joining fee & swipe card) ($380.00) Nominated Family 2011/2012 ($280.00) Family Membership Midweek 2011/2012 ($110.00) Midweek membership New Midweek (Includes joining fee & swipe card) ($180.00) New Pensioner (Includes joining fee & swipe card) ($110.00) Pensioner 2011/2012 ($70.00) Pensioner Member inc Maint. Levy Junior (Under 18) 2011/2012 ($70.00) Full Junior Membership New Junior (Under 18 - Includes joining fee & swipe card) ($110.00)
Payment System *	PayPal secure credit card payment
Your Name * Your First & Last name
Your E-Mail Address * A confirmation email will be sent to you at this address
Home Phone Home Phone Number
Mobile Number Mobile Phone Number
Names of family members Please list the names of all other members of your family whom are part of your family membership. For Juniors, please also list their age
Date of Birth
Country*
State*
City*
Street*
ZIP*