Patterson Lakes Radio Model Yacht Club

_\) _\) _\) Patterson Lakes Radio Model Yacht Club _\) _\) _\)

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Membership

Please enter your membership information in the form below and and pay your membership dues for the year. You may do this by Electronic Bank Transfer (our prefered method) using the following information:

Account ....... Patterson Lakes Radio Model Yacht Club

Bank ........... Westpac, Frankston

BSB ............ 033 362

Account No . 104 203

PLEASE ENSURE YOUR ELECTRONIC TRANSFER INCLUDES YOUR NAME.

If requiring to make payment by other than direct credit please make arrangements with the Treasurer.

Surname A value is required. Given Name A value is required.
Year of Birth:
Address A value is required.
Town A value is required. Postcode A value is required.

Phone - Home Business Mobile

Emergency Contact
Name Phone No

Do you have a current Boat licence Select:

Expiry Date (Month/Year)

Have you ever been barred or excluded from any other club Select:

Membership Catagories

Intial Joining Fee (not applicable to Juniors and Non Sailing Member and current members) $10

Are you a new member :

Plus

Senior - including VRYA Levies & Insurance
Senior Associate - Levies/Insurance paid at another club
Non Sailing Member
Junior Member
Life Member

Membership Type

Note that new members joing after 1st November and before the 30th April pay 50% of above fee.

Amount of Subscription Paid $

Payment Method

Boat Registration Details

One Metre Sail No

Dragon Force 65 Sail No

RG65 Sail No

Dragon Flight 95 Sail No

Laser Sail No

Other Classes and sail numbers

IDEMNITY
I agree to abide by the conditions of the PLRMYC events as contained in the Notice of Race, Sailing Calendar, Sailing Instructions, the Racing Rules of Sailing, club sailing etiquitte rules and any Notices published by the Committee. All members taking part in the club organised events do entirely at their own risk.

The Australian Radio Yachting Association (Incorporated) the State Radio Sailing Association, Organizing club(s) and any other parties involved in the organization of this event disclaim: Any and every responcibility whatsoever for loss, damage, injury or inconvenience that might occur to persons and goods, both ashore and on the water as a consequence of entering or participating in club events. At all times the responsibility for saftey and themselves plus the decision to participate or continue rest with the competitor. By paying your annual subscription fee it is deemed that you accept these conditions

Click if you agree to be bound by the Idemnity Please make a selection.

You can obtain a hard copy of our membership form by clicking on this Membership Form link