This form must accompany your completed Membership form and
a cheque to MBTC, PO Box 65090, Mairangi Bay 0630,
Or drop them both into the drop box at club.
Child 1
Name:
Surname:
Age now:
Best phone number on Saturdays:
Can’t hit ball yet.
Can hit ball.
Child 2
Name:
Surname:
Age now:
Best phone number on Saturdays:
Can’t hit ball yet.
Can hit ball.
Post form and cheque to MBTC, PO Box 65090, Mairangi Bay 0630, or drop in box at club.
Principal Member
Tick if playing Interclub
Surname First Name
Date of Birth
Postal address
PhoneBusiness
Mobile
persons included in membership
Name Phone DOB Interclub
Name Phone DOB Interclub
Name Phone DOB Interclub
Name Phone DOB Interclub
Fees: go to column which shows number of members in family!
1
2
3
4 +
member
members
members
320 275 265 265 per Senior
members
per Veteran
Over 65 at 31 December 2008
200
195 185 185 per Student Under 22 at 31 December 2008
245 235
230 230 per Intermediate
Under 18 at 31 December 2008
220 205
200 195 per Junior Under 12 at 31 December 2008
170 160
150
145 Payments: Add fees from table above (eg. Column 4: a family with 2 x seniors and 2 x juniors = $820)
$
If total greater than $850, fill in only $850 (maximum fee for a family)
$
Interclub: add $50 per player (does not apply for Midweek Ladies)
$
Court Access Card: add $12
$
Optional Seed foundation contribution: add$10
$
Total
Payment method: Cash
Cheque
Direct
Direct Credits to: 03-0180-0004331-000 Enter Surname and First name in Code fields.
signature: Date:
*Fees include GST for membership until 31st August 2009 and affiliation to Tennis NZ and Tennis North Harbou: $50.65 adults, $40.50 juniors (12yrs & under)
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