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Membership
Please Pay by
Direct
Deposit or Cash
fill out the online form below
and then press the Submit Button.
Wangaratta Pickleball Club Online Membership Registration Form
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Full Name
Full Address including Postcode
Phone Number
Email
Date of Birth DD/MM/YYYY
For Family Memberships other Family Members to be added below Please add Name, Date of Birth and Gender
First
Middle
Last
First Member
First
Middle
Last
Second Member
First
Middle
Last
Third Member
Emergency Contact Name
Emergency Contact Phone Number
Gender
Male
Female
Permission to use Photos for Publicity
Yes
No
Membership Fees (Please Select)
Full Adult Membership $100
Seniors 65 and over $90
Family includes 2 Adults & 2 Juniors $200
Juniors under 18 $50
I will be paying by (Please Select)
Direct Deposit
Cash
Bank Account Details
Please use your Surname as a reference on the Direct Deposit
Submit