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BURNIE DISTRICT GEMSTONE CLUB INC Applications for Membership orm Contact Secretary 0417523729 or Email
[email protected] !o Bo #$%B&rnie Tas #'()I * +e A,,ress !hone +ish to appl- for membership of the B&rnie District Gemstone Cl&b Inc. an, a/ree toabi,e b- the R&les an, Constit&tion of the Cl&b an, the Co,e of !ractice. (or a copy o! t e constit#tion$ please as% a Committee &ember$ t ere is also one on t e notice board !or members to read' Date0 1 si/nat&re0 1222222222222.amil- membership 3 please /i4e names an, ,ate of birth of all chil,ren &n,er the a/eof 56. (or ins#rance p#rposes' 7&nior membership 1 85( 3 5%9. )ne s#per*ising ad#lt. + is s#per*ising ad#lt is t ere !or s#per*ision only and cannot *ote or #se t e mac inery. Date of birth 22222222. Si/nat&re of parent * /&ar,ian 22222222222Total amo&nt pai,0: EES07OININGSUBSCRI!TIONTOTAL ,#nior (12 - 1'/3.00/20.00/23.00Single ad#lt/5.00/35.00/40.00Co#ple (any 2 persons'/10.00/45.00/55.00amily (2 ad#lts /10.00/55.00/5.00 2 c ildren'estricted &embers ip/0.00/25.00/25.00( estricted &embers ip is !or ieldtrips ) 6 it is a 12 mont members ip$ and allosaccess to all +& a!!iliated trips$ pl#s 3 #npaid or%s op days per ann#m.+ ese members are also alloed to attend meetings$ b#t s all not a*e *oting rig ts.' +or;shop fees0 &ll ,a-0 :% 8$hrs9<alf ,a-0 :$ 8'hrs9Sat&r,a-0 :6 8=hrs9Sa>s 1 :( per ho&r pl&s Dail- RateSa>s are char/e, at :( per ho&r or part there of. NE+ MEMBERS ALSO RECEI?E ' DA@S REE AS TRIAL !ERIOD ATER !A@MENTO MEMBERS<I! RECEI?ED. Ann&al s&bscriptions are ,&e an, pa-able on the 5 st 7&l- each -ear.The cl&brooms are open T&es,a-s an, Th&rs,a-s 1 0') am to ( 3 (0') pmSat&r,a-s 1 5)am to 'pm1 confirm >ith secretar-. ll ne members to agree to t is prior to being accepted as members.8 :E ;EE S)<=>:8SE> <EE +E C?;SC)S+8+?+8) 8S > & ;E +) E> 8+ 8 8 8AE.8 S ;8>E ; +E ?ES )?+8E> 8 +EC)S+8+?+8)SignedBlease be ad*ised t at d#e to o#r ins#rance policy$ members beteen t eages o! 1 and 0 a*e !#ll co*er.ny members ose ages are not listed may not be co*ered$ and attendt e cl#b$ !ieldtrips$ and anyt ing to do it t e cl#b at t eir on ris%.>?E +) +8S$ <E SA ++ ,?8) &E&;ES ;E S?E:8SE> ;E+ ) D?>8 + +8&ES$ <E S) SA ++ ) &E&;E ?>E 1 ES 8S +) ?SE S< ) +E C?; E&8SES.8 a*e read and agree to t e abo*e cla#se.Signed8 gi*e permission !or my basic in!ormation to be incl#ded on t e cl#b ebsiteB ame and >istrict=rea