First Name (required)
Last Name (required)
Social PlayCompetitive PlayCoachingRunning introductory clinicsAssisting with introductory clinicsAssisting with administrationOrganising tournamentsCoordinating weekly fixturesAssisting with coordination of fixturesOther
Emergency Contact Name (required)
BPC Membership Fee: $50 NOTE: Membership expires 30/06/20
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Direct Deposit BPC BSB: 034065 Account Number: 306153 Reference: MEM & Your Surname
Declaration: I consider myself to be physically fit and capable of full participation and agree to notify the club if this changes. Furthermore, in the event I am injured I give my permission for event organizers to obtain emergency medical treatment on my behalf.