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    NAME

    DATE OF BIRTH

    AGE YOU TURN THIS YEAR

    MOBILE

    EMAIL

    INSTAGRAM NAME?

    SPONSORS?

    PARENTS CONTACT

    (Name and Mobile Number of a Parent for Members under 18)


    T-SHIRT SIZE

    MENS
    KIDS

    DISCLAIMER


    In signing this form I agree to release NMSR Inc (‘the Club’)., all associated sponsors & Randwick City Council from liability for any injury sustained whilst competing or involved in any club events. I am agreeing to follow the rules of the Club at any club events and the directions given to me by the Club committee members or lifeguards. ADDITIONALLY FOR PARENTS OR GUARDIANS OF MINORS: In signing this form I am aware that I am solely responsible for the actions and safety of my child for the entire duration of their attendance at any Club event.


    SIGNATURE

    (Name and Mobile Number of a Parent for Members under 18)

    DATE

    DIVISIONS (AGE)
    & ANNUAL FEES

    (Tick the box based on the
    age you turn this year)

    (A/B grade)