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Membership Form

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Name*

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Address*

Street Address Address Line 2 Suburb State Post Code

Date of Birth*

Membership Duration*

1-Year Membership

3-Year Membership

Occupation*

Consent to Rules and Regulations*

I hereby apply to become a member of the Southport Sharks Club and request you to enter my name on the register of members, if accepted. I certify I understand and will abide by the Southport Australia Rules Football Club (SARFC) Rules and Regulations.

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