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Member Details
Name:
Date of Birth:
Residential Address:
Mailing Address (if different from above):
Home Phone:
Email:
Guardian Details
Name:
Residential Address:
Mailing Address (if different from above):
Home Phone:
Work:
Mobile:
Email:
Boat Details
Owner of Boat (Full name):
Boat No.:
Boat name:
Website Consent – Guardian to complete (please tick)
I do consent to this junior driver's name/photo to be placed on the AFPGP website in the relevant teams/feature driver areas
I do not consent to this junior driver's name/photo to be placed on the AFPGP website in the relevant teams/feature driver areas
Membership fee
$45
(Pay securely by Credit Card / Paypal)
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