Membership Application or Renewal Form 2021 – 2022Please enable JavaScript in your browser to complete this form.Parent/Carer Information - Step 1 of 3Type *Renewing MembershipNew MembershipParent/Carer Name 1 *FirstMiddleLastParent/Carer 1 Gender *MaleFemaleParent/Carer 1 Date of BirthParent/Carer 1 - Email *Parent/Carer Name 2FirstMiddleLastParent/Carer 2 GenderMaleFemaleParent/Carer 2 Date of BirthParent/Carer 2 - EmailResidential Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeNextSwimmer 1 Name *FirstMiddleLastSwimmer 1 Date of Birth *Swimmer 1 Gender *MaleFemaleAdd Swimmer 2Tick to add another SwimmerSwimmer 2 Name *FirstMiddleLastSwimmer 2 Date of BirthSwimmer 2 Gender *MaleFemaleAdd Swimmer 3Tick to add another SwimmerSwimmer 3 Name *FirstMiddleLastSwimmer 3 Date of BirthSwimmer 3 Gender *MaleFemaleAdd Swimmer 4Tick to add another SwimmerSwimmer 4 Name *FirstMiddleLastSwimmer 4 Date of Birth *Swimmer 4 Gender *MaleFemaleIf renewing "Membership" click NEXT again.NextI/We (type Names) *agree to abide by the By-Laws and Constitution of the Bracken Ridge Swimming Club. *YesWhen you click "Submit" you will be re-directed to the Wizards Shop to purchase your Membership. Remember: Parents/Carers are Free.Submit Application or Renewal
