Renew Membership

Membership No : *

Date of birth : *

OTP *

Membership Details

Membership* Assoc - 1 Year (Cyclical) - $5.50 Assoc - 3 Year (Cyclical) $8.80 Assoc - 5 Year (Cyclical) $11.00 RSL - Annual 1 Year - $5.50 RSL - Annual 3 Year $8.80 RSL - Annual 5 Year $11.00

Personal Details

Given Name*

Surname*

Date of Birth*

Gender*

Male Female

Occupation

Language Spoken

Contact Details

Mobile/Phone No*

Email Address*

Residential Address

Address*

Suburb*

State*

Post Code*

Mailing Address

Tick if mailing address is same as Residential Address

Sync the Address

Address*

Suburb*

State*

Post Code*

Communications

Do you wish to recieve marketing & promotional information?*

Yes No

Do you wish to recieve gaming information?*

Yes No

Have you ever had your membership to a Club suspended or cancelled? **

Yes No

Privacy Statement

I am over the age of 18 years and I agree to be bound by the memorandum and articles of association and by-laws, and any other regulations of the City of Fairfield RSL Memorial Club Limited. I will adhere to the directions of Club Management, including responsible service of alcohol, dress regulations and portray responsible behavior and a sensible approach to gaming. I am aware of the consequences of entering a premises where smoking is permitted.

I consent to receiving marketing materials, advertising materials and other offer materials from City of Fairfield RSL Memorial Club including; but not limited to material relating to prize draws, promotions, entertainment, food, beverage, gaming machines, gaming and the Member’s Loyalty program.

The City of Fairfield RSL Memorial Club Ltd is subject to the provisions of the Privacy Act 1988. The personal information provided by you on this application and attached documents will be used to process your membership application. Failure to provide all of the requested information may result in your application being rejected. You have a right to access and correct any of your personal information that the Club holds about you.

The Club does not usually disclose your personal information to any other organisation or person unless there is a legal requirement to do so. The Club may disclose your information to third parties that provide services under contract to the Club. These contracts require the third party to keep your personal information confidential and secure.

Your personal information, including information about you obtained as a result of you placing your membership card in a gaming or other club machine (not ATM’s), may be used by the Club for marketing purposes to improve our service and to provide you with the latest information about those services, any new related services and promotions.

Billing Address

Full Name*

Email Address*

Address*

Suburb*

State*

Post Code*

Pay by Debit or Credit Card