"*" indicates required fields Full Name* First Last Address* Street Address Town/Suburb Postcode Phone NumberEmail Address* Date Of Birth* DD slash MM slash YYYY Age (as at 01/01/2024)* Gender* Male Female Prefer Not To Say Medical Conditions/Allergies*Emergency Contact Emergency Contact Number*Division InformationPreferred Division* Kahunas (Over 45s) Masters (0ver 35's) Opens (0ver 18's) Juniors (Under 18's) Cadets (Under 16's) Girls/Womens Gromets Super Groms Social Member MEMBERSHIP FEES (includes a FBI T-shirt)OPENS/MASTERS/KAHUNAS $70 JUNIORS/CADETS/GROMMETS $50 SUPERGROMS $30 SOCIAL MEMBER $30 FBI HOODIE - ADULT $70 FBI HOODIE - KIDS $60Super GrometsSUPERGROMS (Please note that this is an assisted surfing division. I agree that my child will be supervised on the beach and be accompanied by a parent/guardian in the water while surfing.) Please tick your agreement to this condition and understand that your child will NOT surf if unsupervised. Yes, I agree Consent I agree to the FBI policy and Membership Declaration.I agree and understand that safety at all times is entirely my sole responsibility. I know that the ocean and surf can be dangerous and I will indemnify and will keep indemnified Forster-Tuncurry Boardriders Inc. (FBI) and committee, all organisers and all sponsors from any and all responsibility involving any and all participation I undertake in FBI. I also agree to the use of any photos depicting me on social media. NB: For insurance purposes we recommend all FBI members are also members of Surfing NSW.Signature*Over 18's Member/Under 18's Parent/Guardian to signMembership Declaration Make sure you thoroughly read through our membership declaration before submitting this form. A copy can be downloaded here - Membership DeclarationPayment InformationTotal Credit Card* Cardholder Name Card Details NameThis field is for validation purposes and should be left unchanged.
