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AUSTRALIAN MYTHS & LEGENDS INC.

P O ?xml:namespace prefix = "st1" ns = "urn:schemas-microsoft-com:office:smarttags" />BOX 96, BULLEEN VIC 3105

2010/2011

APPLICATION FOR MEMBERSHIP

APPLICANT’S FULL NAME:                                                                       

PARTNER’S NAME                              

APPLICANT’S ADDRESS:                                                                                      

                              POSTCODE                     

HOME TEL:                                              MOBILE TEL:                                                   

DATE OF BIRTH:     /       /     EMAILADDRESS:                                           

SINGLET NO (If played with M & Ls before)                

PLEASE CONFIRM ALL YOUR DETAILS ABOVE

I apply for membership of the AUSTRALIAN MYTHS & LEGENDS INC. Basketball Club (the “Club”) and enclose payment of $30.00 being the annual membership fee for the period 1 July 2010 to 30 June 2011

I agree to promote the philosophy of the Club and compete with a spirit of fair play and abide by the decisions of the committee. In consideration of acceptance of my membership, I hereby waive all claims, or cause of action which I might be entitled to have against the Club and its committee, office bearers or any members whatsoever involved in any of the competitions, practice or functions conducted as part of the Club’s purpose and/or function.

SIGNED                                                                                                                                                     DATED                              

(PLEASE FORWARD YOUR APPLICATION AND PAYMENT OF $30.00 MEMBERSHIP FEE TO:

Ian Farr, President @ 8 Plummer Road, MENTONE VIC 3194)