ONLINE MEMBERSHIP FORM
Thank you for your interest in joining our Club. Please fill out this form and a Committee Member will contact you to finalize your Membership.
JOIN NOW
 
New Membership or Renewal? *



 
What is your existing Membership Number?

Simply leave blank if you do not know.
 
What's your first name? *

 
What's your last name? *

 
Your date of birth? *

 
Best contact number? *

 
Your mobile number?

 
What's your residential address? *

Eg. 468 Rode Road, Chermside QLD 4032
 
What's your first name? *

 
What's your last name? *

 
Your date of birth? *

 
Best contact number? *

 
Your mobile number?

 
What's your residential address? *

Eg. 468 Rode Road, Chermside QLD 4032
 
How did you hear about the snooker club? *


 
What Membership Type? *

Details can be found under "Pricing Info" on our website, www.kedronwavellsnooker.com.au. If unsure, we can discuss options during your confirmation appointment.



 
You are requesting to join as a Bronze Member for 2018/2019. Please accept the below Membership Terms & Conditions? *

 
You are requesting to join as a Gold Member for 2018/2019. Please accept the below Membership Terms & Conditions? *

 
Select a payment frequency? *

Membership are valid from 1st February 2018 to the 31st January 2019. Your Membership Amount will be pro rated depending on your Membership start date.


 
And how do you wish to pay for your membership? *

If you selected Monthly as your payment frequency, all monthly payments are due on the 28th of each month (or the next business day).



 
Bank Account details?

Your Total Membership Amount will be confirmed in person. Payment will not be processed until after your Membership is finalized.
 
Account Name *

 
BSB Number *

 
Account Number *

 
Credit Card details?

Your Total Membership Amount will be confirmed in person. Payment will not be processed until after your Membership is finalized.
 
Visa or MasterCard *


 
Card Number *

 
Card Expiry *

 
CVC *

 
Ezypay handles all our monthly Direct Debit & Credit Card Payments. Do you accept their Terms &
Conditions? *

 
We will contact you and provide details on how to make payment.

 
Are you an existing member of Club Chermside? *

     
 
We will need to sight your Club Chermside Card to verify your Membership. If we cannot verify your Club Chermside Membership, we will arrange a Membership for you. This will cost you an additional $2.00 for the year.

 
As it is compulsory for you to be a Club Chermside Member, we will arrange a Membership for you. This will cost you an additional $2.00 for the year.

 
Please upload your photo ID?

We will require to a copy of your Photo ID (Valid Drivers Licence or Proof of Age Card) and we will need to sight this in person. You do not need to upload this now, but it will save time if you do.
 
Select a preferred time to finalize your membership? *

In order to finalize your Membership, we will arrange a time to meet us at the Club. We will confirm the details on this form, give you a tour of the Snooker Room and give you your Door Key and Light Meter Card. This will take approx. 15-20 minutes. **Please note, if this is a Renewal, please select "Renewal" below as this will not be needed.**

Thank you, {{answer_pYWwndXsj22T}}. A member of the Committee will contact you within 48 hours to confirm a time to finalize your Membership.
Restart
Powered by Typeform
Powered by Typeform