Registration – Raumati Swimming Club

Select Membership Type

New member? *New membership to this clubTransferring my primary membership from another club

If transferring, from what club?

Membership Category

Personal Details of Member

Prefix

First Name *

Middle Name

Last Name *

Date of birth *

Gender *MaleFemaleOtherRather not say

Please select your ethnicity

Primary Contact

Please enter at least one primary contact (the Club would prefer two, but recognises this is not always possible. Please ensure that you update the club should primary contact details change in the future, thank you)

Prefix

First Name *

Last Name *

Street Address *

Suburb *

City *

Postal Code *

Phone 1 *

Phone 2

Email Address *

Secondary Contact

Secondary ContactAdd secondary contact?

Prefix

First Name

Last Name

Street Address

Suburb

City

Postal Code

Phone 1

Phone 2

Email Address

Other Information

Please indicate any areas that may be of benefit to the club (For example: qualified IOT; director on boards; relevant work experience.)

Updates

From time to time the club, region and SNZ would like to circulate information to the membership. Please tick the box (es) if you wish to receive information on the following:

QUICK LINKS

UPCOMING EVENTS

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