By submitting this form you confirm the follwing terms :

• Your membership covers the period to 30 June of the current financial year and my membership falls due by that date each year
• Be bound by the Club constitution/rules
• Abide by the Concessional Registration Scheme (CRS) guidelines (if applicable)
• Agree to release the Club from any liability arising from being engaged in any Club activity
• Your name can be used as appropriate for Club purposes unless I specifically request otherwise.

Note: As a potential new member please bring this completed form to the next Monthly Meeting for Committee approval. Meetings are held the 1^st Tuesday of each month (except January) at the Canberra Deakin Football Club, 3 Grose Street, Deakin, commencing at 7:30pm. Come along at 6:30 if you would like to have dinner beforehand.

If paying by cash – bring updated form to the next monthly Meeting;

Cheque – make payable to EJ-EH Holden Club ACT and post with updated form to PO Box 208 MAWSON 2607;

EFT – make payment to BSB  062914 Account No 10338656 at Commonwealth Bank (inc. SurnameFirstname)