New Member Application Form PhoneThis field is for validation purposes and should be left unchanged.Membership TypeMemberships expire on the 30th June1 Year Financial Membership $103 Year Financial Membership $25ADD ONOne year only SOCIAL BOWLING + $20 FULL BOWLING + $105 PIPE BAND + $30 (Playing Member) PIPE BAND + $20 (Non-Playing Member) JUNIOR PIPE BAND NONE Prefix Mr Mrs Miss Ms Other Name(Required) First Last Address(Required) Number and Street Name Suburb State Postcode Mobile Phone(Required)Home PhoneEmail(Required) Date of Birth DD slash MM slash YYYY Gender Male Female Other Consent I am applying for membership at the venue and of its ClubMIX rewards program.Rewards Xtra If you wish to sign up to the Rewards Xtra program, you will be issued a loyalty player card that you can link to the YourPlay scheme. YourPlay gives you the power to track how much money and time you are spending as you play. If you wish to sign up to YourPlay please see the staff at the venue to find out more information. Consent Tick this box if you do not wish to receive communications including promotional materials, associated benefits, and offers that include alcohol and gaming activities.Team Rewards (Sponsorship) Nominate your favourite local sporting team and with every food and beverage purchase made, we will also allocate the same amount of points to your nominated teams. Team Rewards points are tallied up over a calendar year and result in sponsorship of cash and vouchers.Nominated Team:Please chooseCarisbrook Football Netball ClubColts Phelan Cricket ClubDunolly Golf ClubMaryborough Giants Football Netball ClubLaanecoorie Cricket ClubMaryborough Croquet ClubMaryborough Cricket ClubMaryborough Football Netball ClubMaryborough and District Gun ClubMaryborough Masters Football ClubMaryborough Tennis ClubNatte Bealiba Football Netball ClubTalbot Football Netball ClubMembership Card Delivery(Required) Pick up from Reception - FREE Post it to me - $2 Consent By applying for membership, I agree to be bound by the constitution and by-laws of the Maryborough Highland Society Inc. I also agree to being contacted by the Venue with latest news and offers, including gaming, wagering and Keno (unless you have opted out by ticking the contact preferences box). The Maryborough Highland Society Inc. complies with the Privacy Act 1998 and the National Privacy Principles. A copy of the Club’s Privacy Policy can be found on the Highland Society Website www.highlandsociety.com.auTotal Credit Card Δ
