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Club Membership Fees: $40 for 1 year; $60 for 2 years; $90 for 3 years. The Membership Fee covers Club Members under the Club's Public Liability and Accident Insurance Policy and the administration of the website. If you have any questions please use the "Contact Us" page.

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Surname *

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Mobile Phone Number *

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Home Address Street Name and Number *

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State *

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Date of Birth if under 18 years old

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Emergency Contact Phone Number *

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Emergency Contact Relationship

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If you have a First Aid Certificate, what date does it expire?

Leave without a date if you do not have a current certificate.

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How You Found Out About Us *

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Membership Fee Payment Details *

Membership Fees: $40 for 1 year; $60 for 2 years; $90 for 3 years.

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I Have Read and Accepted The Following Waiver: *

PLEASE READ CAREFULLY

Part of the Membership Fee pays for Membership in The Confederation of Bushwalking Clubs and Personal Liability and Sports Accident/Injury Insurance.

Informed consent: I agree that when participating in ANB Inc (the Club) activities, I do so voluntarily & at my own risk. I understand that some activities may be dangerous and may expose me to risk that could lead to injury, illness or death or to loss of or damage to my property. Those risks may include, but are not limited to, slippery and/or uneven surfaces, rocks being dislodged, falling at edges of cliffs or drops or elsewhere, risks associated with crossing creeks, hypothermia and heat exhaustion. To minimise the risks I will endeavour to ensure that any activity in which I participate is within my capabilities and that I am carrying food, water and equipment appropriate for the activity. I agree to advise the activity leader if I am taking any medication or have any physical or other limitations that might affect my participation in the activity. I agree to follow the reasonable directions of the activity leader and make every effort to remain with the rest of the party during the activity. I have read or heard and understand these requirements. I have considered the risks before choosing to sign this form. I still wish to participate in the activities of the Club. I agree by signing this form, to waive any claim for damages arising from my participation in Club activities that I may have against the Club, the leader or other participants in tort or contract.

I agree to abide by the Club's Constitution and Code of Conduct.

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