Register as a Queenstown Senior Member for the 2009 - 10 Tennis season

Registration can be completed by either:

• Complete the form below or
• Download, complete and post a completed form into Queenstown Tennis Club, P O BOX 1019, Queenstown 9348

First Name(s)

Surname

Occupation/Business (optional)

Player Type

• Male
• Female

Date of Birth

Top Dog Number (if known ) (www.tennis.org.nz)

Address

Email

Home Phone

Work Phone

Mobile

Membership Type

• Senior
• Senior 60+
• Couple
• Snr 60+ Couple

Payment Type

• Cheque
• Cash
• Direct Online Banking

Queenstown Tennis Club Inc - Bank Account Number - ASB Queenstown 12-3234-0099799-00

Declaration

I have read and consent to the membership declaration