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EILDON PARK TENNIS CLUB

Eildon Parade, Rowville Clubhouse Ph: 9764 1109 Postal Address : PO Box 2379, Rowville VIC 3178 www.eptc.org.au Membership Secretary : Stuart Draffin 0408 778 658

2011/12 - MEMBERSHIP APPLICATION FORM

SURNAME FIRST NAME (list all family members if a family membership is proposed) TENNIS VIC REGISTRATION NUMBER BIRTHDATE

ADDRESS:_____________________________________________________________ SUBURB:______________________________________POSTCODE:_____________ PHONE No (H)_______________________(Mob)______________________________ EMAIL ADDRESS:_______________________________________________________ OCCUPATION/TRADE/SKILLS:____________________________________________

I provide consent to photographs of myself and family members, taken when involved in EPTC activities, being displayed on the EPTC web site for public viewing Circle NO if you do not consent

To assist us in providing the most relevant services that are of interest to you, please indicate below your preferences in playing tennis at Eildon Park TC (please tick the appropriate boxes): Weekend : Options WDTA Juniors Saturday AM WDTA Juniors Sunday AM WDTA Seniors Saturday PM Tennis Vic Pennant (Winter only) Saturday Social (internal - 4.30-6.00pm) Tuesday Mid week Ladies Wednesday Mid week Ladies Wednesday Mid week Mens Thursday Mid week Ladies Friday Ladies Social (internal) Monday Mixed Doubles (KDNTA) Monday Ladies Doubles (WDTA) Monday Mens Doubles (WDTA) Tuesday Mens Doubles (KDNTA or WDTA) Wednesday Mixed Doubles (KDNTA or WDTA) Thursday Mens Social Doubles (internal) Casual social play Coaching Tick

Week Days :

Week Nights :

Other :

FEE CALCULATION:
MEMBERSHIP: OTHER PAYMENT REQUIRMENTS: TENNIS VICTORIA REGISTRATION (compulsory Tennis Victoria fee except where EPTC is not your Primary Facility*. This also provides Personal Accident Insurance). ASSETS LEVY SINGLE $93.00 $ COMPETITION FEE (per season, per participating player) TOTAL COST $57.00 $ $98 Family $ OR $28 Per Individual

FAMILY

$165.00

$20 (per mship) To be advised. Depends on the Comp played

$20
$

JUNIOR STUDENT (full time) AGED 60 +

$73.00 $73.00

$ $

Old key returned :_________________________ New Key issued :______________________________ Tag(s) issued :____________________________ Receipt No:__________________________________

Notes : Annual Membership fees are for the period of 1 July to 30 June. Renewals after 31 October incur a $10.00 late fee. Pro-rata fees apply to the Club membership fee if joining in the quarter commencing November (75%), February (50%) or May (25%) for new members only. Existing members who do not initially renew their membership and seek later in the membership year to renew, are NOT eligible for pro rata membership. The full membership fee is payable. If your membership has lapsed for a period of two membership years or greater, you are eligible for pro-rata fees when rejoining. Individuals over 18 are ineligible for inclusion within Family Membership unless they are still playing Junior competition. Fee includes $5.00 key levy. Court keys are issued upon payment and return of old key. A fee of $5.00 applies if the old key is not returned. (When returning the old key wrap it in glad wrap to prevent loss) Cheques to be made out to EILDON PARK TENNIS CLUB. Please send forms and cheques to the Postal Address listed above. Privacy Statement - Eildon Park Tennis Club collects members information for the purpose of providing Club services and communications related to tennis and for related purposes, which can be reasonably expected. Your membership information will be provided to Tennis Victoria as required by our affiliation. Membership/personal information will be forwarded to Tennis Victoria to provide membership services. Except where permitted or required by law, or where your consent is obtained, this information will not be disclosed to third parties. Individual members can access their personal information through Tennis Victoria and Eildon Park Tennis Club upon reasonable notice.

 Primary Facility is usually where you play most of your tennis. If you are competing in Tennis Victoria Pennant competition it is recommended that you name your Pennant Club as your Primary Facility