5 Year Renewal Application

    Your Current Membership Details

    Prefix (required)

    First Name (required)

    Last Name (required)

    Current Membership Number (required)

    Has your address changed?

    NoYes

    Please provide your new address details:

    Street Address (required)

    Suburb (required)

    State (required)

    Postcode (required)

    I hereby certify that I am over eighteen (18) years of age. I will faithfully observe all rules and by-laws of the Club. I understand that from time to time, Redcliffe Leagues Club will communicate with me using information provided on this membership application form and from member loyalty systems, as per the Club’s Privacy Policy. I understand that I can opt out of communications at any time by informing reception staff.