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Membership TypeMembership TypeNew MemberRenewal of Membership

I/we agree to pay the member subscription as per the scale below which is due 1st July each year.I/we agree to pay the member subscription as per the scale below which is due 1st July each year.YesNo

Payment ForPayment ForBeginners 4 week course (Includes Joining Fee, Membership & 4 x Ground Fees) $85Initial joining fee $25Single membership fee $25Dual membership fee $30Weekly Ground Fees $4

Annual Renewal OptionsAnnual Renewal Options12 monthly Instructors membership $100 incl. Renewal & Ground Fees12 monthly General membership $160 incl. Renewal & Ground Fees

Paws Awhile MagazinePaws Awhile MagazinePlease Post ($14 postage per annum)I will collect Paws AwhileEmail Address for Paws Awhile

Email Address

Is your dog vaccinated against: (proof of vaccination is required)Is your dog vaccinated against: (proof of vaccination is required)HepatitisParvovirusDistemperKennel Cough

Title

Full Name

Address

Phone Number

Email Address

Are you a member of Dogs NSW?Are you a member of Dogs NSW?YesNo

Is your dog registered with Dogs NSW?Is your dog registered with Dogs NSW?YesNo

Dog Breed

Pet Name

Sex

Date of Birth

Class

Where did you hear about MMW

Pensioner Discount ApplicablePensioner Discount ApplicableYesNo

In submitting this form I/we indemnify the Club against any claim for damages for personal injury, however caused.

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