2024/2025 - Associate Membership Registration Form
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Membership Fees
 *
Required

Account Name: Kennett River Surf Life Saving Club BSB: 033208 Account Number: 122091

Use your Surname and First initial as the reference.

Type in the reference you used, receipt number and date processed.

For Example: J Smith, 3822670, 01/02/2023

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Residential Address (PO Boxes cannot be accepted) *
Adult 1 - Full Name, Date of Birth, Email, Mobile Phone Number. For Example: Jo Smith, 01/01/1999, josmiith@krmail.com, 0400 100 100 *
Adult 2 - Full Name, Date of Birth, Email, Mobile Phone Number.
For Example: Jo Smith, 01/01/1999, josmiith@krmail.com, 0400 100 100
Child 1 - Full Name, Date of Birth
For Example: Jo Smith, 01/01/1999
Child 2 - Full Name, Date of Birth
For Example: Jo Smith, 01/01/1999
Child 3 - Full Name, Date of Birth
For Example: Jo Smith, 01/01/1999
Child 4 - Full Name, Date of Birth
For Example: Jo Smith, 01/01/1999
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