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    CAMPSIE SOUTH BOWLING & RECREATION CLUB LTD
    Cnr Alfred & Jarrett Streets, Clemton Park NSW 2206
    Telephone: (02) 9787-1099 Facsimile: (02) 9787-2391
    ABN 58 001 050 040
    APPLICATION FOR MEMBERSHIP - 2019 to
    Includes RNSWBA Affiliation Fees


    PLEASE USE BLOCK LETTERS
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    Date of Brith
    Residential Address:
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    Drivers Licence no:
    List membership of other Clubs:
    Have you ever been refused entry or dealt with on any matter by any Licensee of a Club or Hotel, or any Committee of such? If so, write particulars below:
    Privacy Acknowledgement: The Club’s privacy policy has been explained to me and I receive information about Club functions, events and or promotions.

    Proof of Age sighted and attached: