PAPAMOA SURF LIFE SAVING REGISTRATION FORM Step 1 of 2 50% Membership Type*NEW MEMBERTRANSFERRING MEMBERRETURNING MEMBERPrevious Club(If transferring member)REGISTRATION TO SURF LIFE SAVING NZ- COMPULSORY*I will complete the SLSNZ registrationhttps://webportal.surflifesaving.org.nz/new-membership/ Family Last Name*(Account name)Email* Postal Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Primary Contact Name*Mobile*Relationship To Member*JUNIOR SURF Price: $75.00 Quantity: Please note it is mandatory for every JS athlete to be accompanied by an AM. ASSOCIATE MEMBER* Price: $30.00 Quantity: ALL junior surf memberships must have an assoicate member ( 1 per family, unless parent is a lifeguard)FAMILY MEMBER Price: $225.00 Quantity: All family members must reside at one address.LIFEGUARD MEMBER Price: $60.00 Quantity: Lifeguard membership must be over 14 years. CLUB DONATION Price: $10.00 Quantity: Help us to keep saving lives! Did you know a rescue tube costs $120! Your support and donation helps keep our beaches safter, thank you! Tax deductible over $5.Membership Total $0.00 Additional InformationAny known medical conditions of registered members.Declaration*YesNoI hereby declare I have read and understood the Terms, Conditions and Declarations as noted below and agree to adhere to them and i have completed the NZSLS registration for all memberships.Date Date Format: MM slash DD slash YYYY Your family can also volunteer to help our club in any of the followingBBQ RosterGear MaintenanceHelper on the BeachFundraisingSurf Official/Recorder - I would like to know more!Coaching - I would like to know more!LifeGuarding - I would like to know more!Club SponsorshipPlease provide a contact name & number Name First Last Date of Birth Date Format: DD slash MM slash YYYY SexMaleFemalePhoneMembership CategoryJunior SurfAssociate MemberLifeguard MemberFamily Primary Contact*YesNo#2 Further Family Members To Enrol?*NoYesName First Last Date of Birth Date Format: DD slash MM slash YYYY SexMaleFemalePhoneMembership CategoryJunior SurfAssociate MemberLifeguard MemberFamily Primary Contact*YesNo#3 Further Family Members To Enrol?NoYesName First Last Date of Birth Date Format: DD slash MM slash YYYY SexMaleFemalePhoneMembership CategoryJunior SurfAssociate MemberLifeguard MemberFamily Primary Contact*YesNo#4 Further Family Members To Enrol?NoYesName First Last Date of Birth Date Format: DD slash MM slash YYYY SexMaleFemalePhoneMembership CategoryJunior SurfAssociate MemberLifeguard MemberFamily Primary Contact*YesNo#5 Further Family Members To Enrol?NoYesName First Last Date of Birth Date Format: DD slash MM slash YYYY SexMaleFemalePhoneMembership CategoryJunior SurfAssociate MemberLifeguard MemberFamily Primary Contact*YesNo