Application For Squash
Club Membership
One Form per Key Tag Please:
Surname:
First Name:
Sex:
Male / Female
Postal Address:
Date of Birth:
Home Phone:
___________________________
Occupation:
Work Phone:
___________________________
Mobile Phone:
Email Address: _____________________________________________
I wish to apply for membership of the Mitchell Park Squash Club. I agree to abide by the Rules of the Club and have
enclosed payment for the following membership (  your membership):
Signature: ________________________
Membership at Mitchell Park: (subscriptions may be subject to abatement from 1st September)
Category 1 – Competitive Player
 Full Senior
 Married Couple

Family
 Junior
 Employed Junior
 Tertiary
to to to to to to -
28 February
28 February
28 February
28 February
28 February
28 February
$ 355.00
$ 595.00
$ 650.00
$ 105.00
$ 155.00
$ 175.00
(unlimited)
(unlimited)
(unlimited)
(hours restricted)
(unlimited)
(unlimited)
Category 2 – Social Player (Non Competitive)
 Off Peak
to 28 February
 Corporate
to 28 February

Non Playing
to 28 February
 Pay to Play - Annual Fee
to 29 February
Pay to Play - Top Up
$ 245.00
(hours restricted)
$ 310.00 per keytag (must be at least 2, unlimited)
$ 130.00
(non playing)
$ 130.00
(includes 300 mins)
$ 40.00
(300 minutes)
All Members

Key Tag
$ 10.00
TOTAL :
(all new memberships)
_________
PLEASE NOTE: There is no refund of subscription when leaving before the end of the subscription period.
OFFICE USE ONLY:
Method of Payment:

Cash
Where Paid:


Pro Shop
Posted to:
 Cheque No: __________ 
 Bar
PO Box 45111, Waterloo, Lower Hutt
Amount Paid: $________________

EFTPOS
Office Slot
Date Paid: ____/____/____
Payment received by: _________________________
Signature:_________________________
……………………………………………………………………………………………………………………...
Data Entered by : __________________________
Date Entered onto computer : _______________
Online Username __________________________ Online Password _________
Newsletter_________
Descriptions of Membership
The Club’s subscription year is
1 March - 28 February
the following year.
Memberships may be periodically reduced during the season as the length of the membership options shorten.
Pay to Play key tags stop working once the time remaining has been used up. Time can be topped up at the rate of
$40.00 = 300 minutes.
________________________________________________________________________________________________
During your relationship with the Mitchell Park Squash Club you authorise us and our members to collect and hold personal information about you.
Under the provisions of the Privacy Act, unless requested otherwise, such information may be:
held until the club believes it is not necessary to keep it any longer; used for the purpose of the club;
disclosed to any member of the club and any organisation and its members who the club is affiliated with.
You have the right to have access and request correction of the information.
There is no tennis membership offered for the Mitchell Park Tennis & Squash Centre, but as a member of Mitchell Park Squash Club you will be able to hire the courts
at the cheaper casual rate. Mitchell Park Squash Club operates as an independent sub-committee of the Hutt Valley Tennis Association.
Membership Types:
Title
Description
Subs to 28 Feb
Full Senior:
Unrestricted playing rights.
Can be graded and play Interclub and all tournaments.
$ 355.00
Married Couple:
Unrestricted playing rights.
Can be graded and play Interclub and all tournaments.
Two adults must live at the same address.
Couple are in a married or defacto relationship.
Equivalent to two senior memberships.
$ 595.00
Family:
Equivalent to a married couple
plus all the children who meet the junior criteria.
Junior children must live mainly at the same address as the
seniors. Playing restrictions for the children same as Juniors.
$ 650.00
Junior:
Must be under 19 years of age as at 28 February and
not in full time employment.
Cannot book courts 4:45 – 9:30pm weekdays or 2-6pm
weekends or public holidays with other juniors.
Playing with seniors is okay ( the senior key tag needs to
be activated first ). Can play Interclub and all Tournaments.
$ 105.00
Employed Junior:
Must be under 19 years of age as at 28 February
Unrestricted playing rights.
$ 155.00
Tertiary:
Must be a full time tertiary student and
provide documentary evidence as such.
Unrestricted playing rights.
$ 175.00
Off Peak (Social)
Cannot play 4.45pm – 7.00pm weekdays
or 2pm – 6pm weekends. No grading.
Cannot play Interclub and Open Tournaments.
$ 245.00
Corporate (Social)
Fees to be charged to the company.
Minimum of two key tags per company.
Cannot play Interclub and Open Tournaments.
Able to play in Club ungraded tournaments only.
$ 310.00 per key tag
Non Playing (Social)
Access to the building for use of the sauna,
$ 130.00
showers and bar (which are not public
facilities). No playing rights.
________________________________________________________________________________________________
Pay to Play (Social)
No playing restrictions.
Able to play in Club ungraded tournaments only.
Any unused minutes on 28 February will be forfeited.
$130.00 Annual Fee
$ 40.00 for 300 mins