VRWC Membership Application or Renewal Note : Only current financial members of VRWC may contest RWA and VRWC Championship/Trophy events. VICTORIAN RACE WALKING CLUB Membership 2017-18 VICTORIAN RACE WALKING CLUB Membership 2017-18 VRWC Membership Application or Renewal and Fee for the year 1 October 2017 - 30 September 2018 VRWC Incorporation Number A00 194 28B If you are human, leave this field blank. First Name * of sole or primary family member Last Name * Date of Birth Required for competitors Gender * Female Male Postal/ Street Address * Suburb or Town * Postcode * Phone (home / work) Include State/Region code - ie, 03 for Victoria Phone (mobile) Email * Required for confirmation Emergency Contact * Name, and any critical information Phone Number * Primary - incl state code Altn Phone Number Secondary - incl state code RWA-affiliated primary Club RWV is the default club for Victorians Membership Category Membership Fee Choose Locale * Metropolitan Country / Interstate Melbourne Metro postcodes are: 3000-3207, 3800 Membership Category * Select membership category: Open / Masters / Official [$40] Under 20 - on 30 Sep 17 [$30] Under 16 - on 30 Sep 17 [$20] Under 12 - on 30 Sep 17 [$20] Family - 2 adults plus children [$90] Family - 1 adult plus children [$75] Family - any number of children [$45] A 50 percent discount is applied for country members Total Members * Select Number Family of 2 Family of 3 Family of 4 in this application Category Fee ($) and TOTAL DUE First Name - 2 * of second family member Last Name - 2 Date of Birth - 2 Gender - 2 * Female Male First Name - 3 of third family member Last Name - 3 Date of Birth - 3 Gender - 3 Female Male First Name - 4 of fourth family member Last Name - 4 Date of Birth - 4 Gender - 4 Female Male Payment information Payment may be completed by either direct credit to our VRWC CBA Account: Name: Victorian Race Walking Club BSB: 063 143 Acct # 00800455 or by paying at the check-in desk on a race day; or by mailing a cheque to : The Secretary, VRWC GPO Box 5192 Melbourne, Victoria, 3001 A copy of this completed form will be emailed to you. For enquiries, email our Secretary@vrwc.org.au I intend to pay by: * Bank Transfer Cash - at VRWC Cheque - mail/VRWC Agreement * I agree to abide by the terms and conditions of membership of the Victorian Race Walking Club Inc, and the rules of competition outlined in the current season's VRWC Race Fixture and Competition Rules publication. reCAPTCHA You might need you to tick/click reCAPTCHA (only if it appears) to minimise spam.