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POLISH CLUB LTD / KLUB POLSKI ASHFIELD APPLICATION FOR CLUB MEMBERSHIP For a person of Polish extraction or related by blood or marriage to a person of Polish extraction - Please print details in BLOCK LETTERS in the boxes. - Each section must be completed unless specified otherwise. 1. Fees Please select your desired membership Full yearly subscription Pensioner 2. Personal Details Family Name Given Names Date of Birth Place of Birth Country of Birth Address Suburb Postcode State Telephone Mobile Email 3. Sponsors Name Membership Number Signature 4. Conditions of Membership Dress Conduct Regulations Members and visitors must be neat and tidy at all times whilst on the Polish Club Limited Ashfield premises. Management/ Security are authorized to remove anyone from the premises That are not suitably dressed* Rubber thongs caps singlets overalls short shorts swimwear training apparel and football jerseys are unacceptable For Inappropriate language offensive gestures or racism* Membership may be revoked if these conditions are broken without a refund. That is heavily intoxicated disorderly violent or suspected of taking illicit substances That breaches the Polish Club Ashfield Constitution or any Statutory requirements. The Polish Club Ashfield membership card must be shown to gain entry into the premises. Guests The guest/s of a member must be signed into the Club. Guest/s are required to leave the Club promptly if the member leaves. Declaration* Have you ever a been refused a membership or b dealt with any charge by Managing Body of a Club YES NO 5. Polish Club Limited Annual Report As a result of the amendments to the Corporations Act and to ensure that all members have access to the annual report members may now choose nominate how they want to receive the Polish Club Ltd Ashfield Annual Report by ticking the appropriate box relevant to your desired selection* YES I would like to receive a hard copy of the Annual Report by Mail NO I do not wish to receive the Annual Report 6. Acknowledgement I Acknowledge the conditions set out in this Polish Club Ltd membership form and agree to abide by the rules and regulations established by the Club Constitution board of directors and management. - Each section must be completed unless specified otherwise. 1. Fees Please select your desired membership Full yearly subscription Pensioner 2. Personal Details Family Name Given Names Date of Birth Place of Birth Country of Birth Address Suburb Postcode State Telephone Mobile Email 3. Personal Details Family Name Given Names Date of Birth Place of Birth Country of Birth Address Suburb Postcode State Telephone Mobile Email 3. Sponsors Name Membership Number Signature 4. Conditions of Membership Dress Conduct Regulations Members and visitors must be neat and tidy at all times whilst on the Polish Club Limited Ashfield premises. Sponsors Name Membership Number Signature 4. Conditions of Membership Dress Conduct Regulations Members and visitors must be neat and tidy at all times whilst on the Polish Club Limited Ashfield premises. Management/ Security are authorized to remove anyone from the premises That are not suitably dressed* Rubber thongs caps singlets overalls short shorts swimwear training apparel and football jerseys are unacceptable For Inappropriate language offensive gestures or racism* Membership may be revoked if these conditions are broken without a refund.

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