Become a Member - Vincentia Sailing Club

Company

This field is for validation purposes and should be left unchanged.

Membership Type

Membership Selection(Required)

Please select your membership type.

Family

Individual Adult

Individual Youth / Student (over 18)

Non-Sailing Social Member(s)

Family

Price:

Individual Adult

Price:

Individual Youth / Student (over 18)

Price:

Non-Sailing Social Member(s)

Price:

Total

Personal Details

Primary Adult(Required)

First Last

Name(Required)

First Last

Primary Adult Date of Birth(Required)

Date of Birth(Required)

Primary Adult Email(Required)

Email(Required)

Primary Adult Phone(Required)

Phone(Required)

Emergency Contact(Required)

First Last

Emergency Contact Phone(Required)

Secondary Adult(Required)

Yes

No

Secondary Adult Name

First Last

Secondary Adult Date of Birth

Secondary Adult Email

Secondary Adult Name Phone

Additional Youth (U18) Members(Required)

Yes

No

Additional Youth (U18) Members

Click/press the "PLUS" sign to add additional family members.

First and Last Name

Date of Birth

Gender Identity

Phone Number

Email

Contact Details

Address(Required)

Street Address City State Post Code

Boat Type & Insurance

Supply the following if it applies to you.

Boat Type & Insurance

Click/press the "PLUS" sign to add additional vessels two your membership.

Boat Type

Boat Name

Sail No.

Boat Insurer

Policy Number

Expiry Date

Boat Licence

Supply the following if it applies to you. If it does not apply to your application, simply skip it.

Boat Licence

Click/press the "PLUS" sign to add all applicable Boat Licence Numbers.

First and Last Name

Licence Number

Expiry Date

Working with Children's Check

Supply the following if it applies to you. If it does not apply to your application, simply skip it.

Working with Children's Check

Click/press the "PLUS" sign to add all applicable Working With Children Check Numbers.

First and Last Name

WWCC Number

WWCC Expiry

First Aid Certificates

Supply the following if it applies to you. If it does not apply to your application, simply skip it.

First Aid Certificate

Click/press the "PLUS" sign to add all applicable First Aid Certificates.

First and Last Name

Certificate

Current Until

Membership 2025-26

Membership Type

Personal Details

Contact Details

Boat Type & Insurance

Boat Licence

Working with Children's Check

First Aid Certificates

Acknowledgement

of country