phone4759 9500

New Social Membership Form

Your Details

Title

Surname

Given Names

Street Address

Suburb

Postcode

Date of Birth

Phone or Mobile

Email Address

Membership for which club?

Please help us to get to know you better!

Are you a member of another club?
Jupiter's Casino
Cowboys Leagues Club
Brothers Leagues Club
Other

If Other, please specify

How did you find out about us?
Radio Ad
Television Ad
Word of Mouth
Newspaper Ad
Magazine Ad
Other

If Other, please specify

Favourite music genre?
Jazz
Rock 'n' Roll
Cabaret
Country
Top 40
Other

If Other, please specify

Food preference?
Italian
Indian
Australian
Greek
Asian
Other

If Other, please specify

Why do you like to visit us?
To dine
Gaming machines
TAB/Sports Bar
To dance
Enjoy live music
Promotions
Other

If Other, please specify

What is your preferred promotional prize?
Holiday
Electrical/whitegoods
Spoprting goods
Boat
Cash
Car
Club vouchers
Other

If Other, please specify

What is your favourite beverage?
Beer
Champagne
Spirits
Wine
Cocktails
Soft drink

Declaration and Agreement

I agree that under the constitution I can hold no office, or nominate another person for such office. I have no voting rights at any General meeting of Committee meeting and shall abide by the rules and regulations of the constitution. I understand that the Townsville RSL has a policy to provide members, guests and staff an environment free from harassment and discrimination. I understand that from time to time, Townsville RSL may communicate with me using information supplied on this form; however I can opt out of this communication at any time.
I declare I am over eighteen (18) years of age.

Payment Details

Expiry /

Contact

(07) 4759 9500

139 Charters Towers Rd,
Hermit Park QLD 4812
Australia