Membership Type Please select your membership type * AffiliatedNon-AffiliatedNon-BowlingJunior Personal Details Full Name * Phone (Home) Mobile Email Address * I authorise Everton Park Bowls Club to use my email address for contact and database purposes Address Street Address * Suburb Postcode Additional Details Date of Birth * Present Occupation Parent or Guardian Consent Only complete this section if the applicant is under 18 and applying for Junior membership. Parent or Guardian Full Name Relationship to Applicant Parent or Guardian Mobile Parent or Guardian Email I am the parent or legal guardian of the applicant named above. I consent to their application for Junior membership and I agree to the declaration below on their behalf. Bowls Club History Are you, or have you ever been, a member of a bowls club? * YesNo If yes, please state the name and address of the club/s Do you intend to remain a member of another club? * YesNo Qualifications Umpire YesNo Coach YesNo Masters YesNo If Masters - please select applicable SinglesPairsFours Disciplinary History Have you in QLD or elsewhere been suspended, expelled or refused admission to any bowls club? * YesNo If yes, please state the name and address of the club/s If you have been a member of a bowls club, have you fulfilled all financial obligations? * YesNoNot Applicable Administrative & Playing Intentions Do you, or have you ever held an administrative position in a bowls club? * YesNo If accepted as a member, do you intend to play bowls? * YesNo Declaration If elected to membership, I agree to comply with and be bound by the Constitution and By-Laws of Everton Park Bowls & Community Club Inc. Where the applicant is under 18, this declaration is made by the parent or guardian named above. I agree to the above declaration Your physical signature and payment will be completed when you visit the club to pick up your membership card.