Membership Form - Hervey Bay Game Fishing Club

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Membership / Renewal Form

If you are having trouble completing the form please call Dean 0407 011 270 or email treasurer@hbgfc.org.au

Membership Details & Main Contact

First Name:(Required)

Last Name:(Required)

Address:(Required)

Postal Address:(Required)

Contact Phone:(Required)

Mobile:(Required)

Email:(Required)

Emergency Contact Name:(Required)

Emergency Contact Phone:(Required)

Membership or Renewal:(Required)

Are you?(Required)

Senior Male

senior Female

Junior

Note – A Junior Member is a person under the age of 16 years old.

Date of Birth (for Junior Member)(Required)

Is there a 2nd Membership?(Required)

Yes

No

2nd Membership Details

To ensure HBGFC can provide updates and correspondence to all members, please ensure phone numbers and emails are correct for that membership. Please don’t add the same phone and email for multiple members

Name:(Required)

Address:(Required)

Contact Phone:(Required)

Email:(Required)

Emergency Contact Name:(Required)

Emergency Contact Phone:(Required)

Membership or Renewal:(Required)

Are you?(Required)

Senior Male

senior Female

Junior

Note – A Junior Member is a person under the age of 16 years old.

Date of Birth (for Junior Member)(Required)

Is there a 3rd Membership?(Required)

Yes

No

3rd Membership Details

Name:(Required)

Address:(Required)

Contact Phone:(Required)

Email:(Required)

Emergency Contact Name:(Required)

Emergency Contact Phone:(Required)

Membership or Renewal:(Required)

Are you?(Required)

Senior Male

senior Female

Junior

Note – A Junior Member is a person under the age of 16 years old.

Date of Birth (for Junior Member)(Required)

Is there a 4th Membership?(Required)

Yes

No

4th Membership Details

Name:(Required)

Address:(Required)

Contact Phone:(Required)

Email:(Required)

Emergency Contact Name:(Required)

Emergency Contact Phone:(Required)

Membership or Renewal:(Required)

Are you?(Required)

Senior Male

senior Female

Junior

Note – A Junior Member is a person under the age of 16 years old.

Date of Birth (for Junior Member)(Required)

More than 4?(Required)

Yes

No

Additional Memberships

Payment Section

Senior Male & Female Memberships Quantity

Price: $ 100.00

Quantity

Junior Membership/s Quantity

Price: $ 50.00

Quantity

Note – A Junior Member is a person under the age of 16 years old.

Total

Payment Options(Required)

Credit / Debit Card

Direct Deposit

We appreciate Direct Deposit if possible as the funds go directly to the Club (Stripe/Card fees are not charged when direct deposit is used).

Direct Deposit: Commonwealth Bank
Acccount: HBGFC
BSB: 064426
Account: 10472054

Please ensure you provide an identifying reference so that we recognise your payment.

Please fill in your billing information below for a Credit / Debit Card Payment using Stripe.

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Email Address:(Required)

Credit Card

Card Details

Cardholder Name

Indentifying Reference:(Required)

Please check this before clicking submit.

To take part in the 2024 Game Fishing Tournament do the following:

1. Become a Member or already be a member of an affiliated Q.G.F.A. or G.F.A.A Club
2. Register for the tournament
3. Read the Tournament Rules
4. Fill in the Mothership form

Hervey Bay GARMIN Game
Fishing Club Tournament Form

Hervey Bay GARMIN Game
Fishing Club Mothership Form

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