New Member Application Form

First name: Surname: Email Address: Mobile Number:

First name: Surname: Email Address: Mobile Number:

Street Number and Street Name:

Suburb

Postcode:

State:

Home Phone Number:

Select your Membership Type:

ID Card Number

Comments

NOT living at the same address as you

Contact Name:

Relationship:

Mobile Number:

Address:(Street Number, Street Name, suburb)

As we are a member-run organisation, you will be required to assist in the toy library 3-4 times a year. Please select your preferred roster day:

First Roster Pref:

Second Roster Pref:

Children:

I don't have any Children.

Add Child Reset

Will you be borrowing for a child with disability or developmental delay?

Agree and Submit:

I agree to the Terms and Conditions of membership set out by the

I agree to the Code of Conduct and Child Safe Policy set out by the

I agree to the WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS set out by the

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