New Rego Page 2

Sydney-central coast a'van group inc

ABN 62 842 468 219

2018 - 2019 ReNEWAL Form

Membership of the Sydney-Central Coast AVan Group inc is open to individuals who own an AVan Camper, Caravan, or recreational vehicle manufactured by AVan Campers and Caravans Pty Ltd. including Golf and Knaus products.
By completing this form and submitting payment for the 2018 - 2019 year I/we agree to be bound by the Clubs Constitution together with such operating procedures which apply from time to time.

* Indicates required field

Members Name *

First

Last

Partner's Name *

First

Last

Email *

Phone Number *

Mobile Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Type of Van *

Model *

Other Type of Van *

Please indicate your preference for the delivery of Newsletters and correspondence: *

Payment has been made *

Direct Deposits $40 to:
BSB 032 285 Account No: 485721
Account Name: Sydney-Central Coast A Van Group Inc.
Please use your name as the Reference
or
Please make your cheque payable to:
Sydney-Central Coast A Van Group Inc. for $40 and mail to the Treasurer Mrs June Spencer, 35 Noamunga Crescent, Gwandalan 2259 by 30th June, 2018 with the completed form.

The Sydney-Central Coast Avan Group Inc does not accept any liability that may occur involving a member enroute to, from, or during, any gathering or club function. Participants choose to take part in any club activities at their own risk.

SUBMIT