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Membership Category

Family Membership
Full
Full Boat Owner
Youth
Waka Adult
Waka Family
Swim
Paddler
Windsurf Youth

Family Membership Please complete a separate application for each person

Surname:

Preferred Name:

Email Address:

Home Address:

Post Code:

Home Phone:

Work Phone:

Mobile Phone:

Occupation:

Date of Birth: dd-mm-yyyy (required if Youth under 24)

Guardian:

Questions/Comments

If accepted I agree to be bound by the rules of The Naval Point Club Lyttelton (Inc.)

CONSENT - PRIVACY ACT 1993

Signed:

Date

Proposer:

Seconder:

Name of Boat:

Type of Boat: e.g. Keeler, Trailer Yacht, Power Boat, Dinghy etc.

Sail Number:

Class e.g. Young 88, Noelex etc.

Radio type:

Call sign: