2013 MEMBERSHIP APPLICATION (PDF)

2013 MEMBERSHIP APPLICATION
Complete and sign both sides & post with Cheque/Money Orders to
Maroubra Bodyboarders 14/63 Broome Street, Maroubra NSW 2035
Applicants from Under 18’s must have the form signed by a parent or guardian.
Applications can not be accepted unsigned or without membership fee.
For more info contact mbb2035@hotmail.com or visit www.maroubrabodyboarders.com.au
plus make sure you add us on Facebook www.facebook.com/maroubra.bodyboarders
Please write neatly & clearly, otherwise you will miss out on emails!!!
Name ………………………………………………………………..….…
D.O.B. ……………………….

Age Turning in 2013 ……………

Address ……………………………………………………………………………………………………..
Postcode …………………
Phone ………………………………......... Email …………………………………………………………

2013 membership fee $85
Social Member

(non-competitor)

$50

Divisions (please circle the division(s) you wish to compete in. You can select a max of two divisions)
Cadets 12-14yrs

Grand Masters 45yrs +

Juniors 15-18yrs

Open DK

Open Men

Open Women

Master 35-45yrs

Social Member

T-shirt size (circle)

S

M

L

XL

Ladies 6

8 10 12

Terms & Conditions

In consideration of acceptance of my entry and membership, I intend to be legally bound, do herby for myself, my
heirs and administrators,IBAA inc, NSWBB, Maroubra Bodyboarders, Randwick City Council and affiliates. Surfing
Australia, Bodyboarding NSW and Maroubra Bodyboarders and the contest and event or club sponsors waive, release
and forever discharge any and all rights and claims for damages which may hereafter accrue against the event,
competition, its officials, employees, agents and contest sponsors, of any and all liability and responsibility arising from
any injury received or incurred by participating in this event. I will inspect the event area and surrounding areas and
assure myself that the area is safe for the activity and further agree that the area conditions are safe for the purpose
intended. Further I acknowledge that I voluntarily assume all risks arising from the conditions relating to the event site
and transport to and from the event by myself and others and I will comply with the NSWBB, Maroubra Bodyboarders
or other authority rules and those of the beach space owners and operators. I agree to release all official photographs
and video footage taken during this event and its use by the event organisers and sponsors. I acknowledge that by
bringing my sport, MBB club or NSWBB into disrepute may result in me being disqualified from the club and/or contest
at the discretion of NSWBB, MBB or the contest organizer.

Applicants Signature ……………………………………………………………
Parent/Guardian Signature…………………………………………………………

2013 MEDICAL FORM
Name ………………………………………………………………..….… D.O.B. ……………………….
Address …………………………………………………………………… Postcode ……………………
Phone ……………………………….........Email……………………………………………………………
Doctor ………………………………………………………Doctor Ph. ……………………………………
Emergency Contact ………………………………………………Ph ………………………………………
Condition
Epilepsy

Yes/No

Info

Fainting or Dizzy
Spells
Heart Conditions
Diabetes
Ear Disorder
Asthma
Other ………………………………………………………………………………………………………

I hereby give permission for officials of MBB to seek any medical service that I or my son/daughter
may require in an accident.
Applicants Signature …………………………………………………………… Date ………………….
Parent/Guardian Signature ……………………………………………………………
MBB Code of Conduct
Respect the rights, dignity and worth off all participants regardless of their gender, ability, cultural background or
religion. Comply with all MBB or Randwick City Council terms, conditions and instructions. All members and their
supporters should exhibit a professional and sportsmanlike attitude when representing MBB at any event. Alcohol and
drug abuse will not be tolerated while representing MBB. Co-operate with Committee members, team managers and
organisers of the event. Obscene language will not be tolerated at any time. Avoid any behaviour that brings MBB into
disrepute.
I have read and understood the Code Of Conduct and I agree to adhere to this code whilst a member of
Maroubra Bodyboarders.

Applicants Signature …………………………………………………………… Date ………………….