Manly Leagues Club and Dee Why Membership Form

Once you have completed the form you will be required to come into your chosen club with proof of ID to retain your new membership card.

Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Phone

(###)

###

####

Email

Membership Options

3 years $0

Annual Report Delivery Method

Manly-Warringah Rugby League Club Limited (“Manly Leagues”) Annual Report is available on the website, or you can receive a copy via post by notifying us in writing. To receive a copy electronically, please select your preferred method:

Email

SMS

DECLARATIONS AND CONSENT:

1. I am over the age of 18 years and wish to become a Member of Manly Leagues. I agree to be bound by Manly Leagues Constitution and any rules, policies or by-laws of Manly Leagues that are in force. 2. I understand that membership is not transferrable and the fee, or any part thereof, is non-refundable. 3. I consent to receiving marketing materials, advertising materials and other offer materials from Manly Leagues including, but not limited to, material relating to rewards, promotions, entertainment, food, beverage, gaming machines, wagering, gaming and the loyalty program and I acknowledge I can opt out of receiving gaming machine marketing materials, or all marketing materials, at any time by advising Manly Leagues as set out below. 4. Manly Leagues issues notices to members, such as Renewal notices and Annual General Meeting notices. I nominate any email address and mobile numbers provided by me to the Club as an electronic means to receive such notices. 5. All Manly Leagues members over 18 years of age are entitled to participate in the Manly Leagues loyalty program (excluding directors, employees and contractors, who are subject to restrictions). I agree that my participation in the loyalty program is subject to the loyalty program Terms and Conditions (as amended from time to time). PRIVACY ACT : For Manly Leagues to consider your application, the Registered Clubs Act requires us to obtain, display in the club and in some cases make available, information such as your name and address. Manly Leagues Club will deal with your personal information in accordance with its privacy policy, which is available at on the Manly Leagues website. Manly Leagues may disclose your information to third parties under contract with us and we may use your personal information to advise you of the Club’s services, benefits and offers. We do not otherwise disclose your personal information to third parties unless required by law. RESPONSIBLE CONDUCT OF GAMING: Player Activity Statement Available Upon Request. If you wish to opt out of receiving gaming machine marketing, then please simply see reception at the Club next time you visit or email gaming@manlyleagues.com.au. Patrons of Manly Leagues Club have access to BetSafe comprehensive 24-hour counselling service, call the helpline on 1800 BETSAFE (1800 238 723). For more information, please ask our friendly gaming staff or receptionist.

Date of Declaration and Consent

MM

DD

YYYY