Join Now - Aquis Gold Coast Turf Club

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Name*

Title First Middle Last

Phone*

Email*

D.O.B*

Occupation*

Employer*

MEMBERSHIP*

Select your membership type expires 30/06/2026.

SUB TOTAL

How did you hear of us?*

Website

Radio

News Article

Social Media

TV

Other

Have you ever been convicted in any court of any offense? (other than a minor traffic offence).*

Yes

No

Have you incurred liabilities in connection with horse racing and not discharged same in full or been declared a "defaulter in debts"?*

Yes

No

Residential Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Postal Address

Same as residential address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nomination

We hereby nominate...

First Last

as a member of the Gold Coast Turf Club and are satisfied that he/she is a fit and proper person to belong to this Club. We have read the Applicant’s answers on the front of this form and we believe their responses to be true and correct. Please select a proposer to nominate you as a member. If you do not know another member please mark as NIL.

Proposer Name

Membership Number

Seconder's Name

Membership Number

DECLARATION: By submitting this application, I hereby declare that the answers by me to the foregoing questions are true and correct and that I have not withheld information within my knowledge likely to affect he decision of the Board of the Gold Coast Turf Club, as to the eligibility of my Membership and I agree to abide by the Rules and Regulations of the Gold Coast Turf Club for the time being in force. I further agree to appear before the Board together with my Proposer and Seconder at a date to be mutually agreed upon if the Board so desire.

CONFIDENTIALITY CLAUSE: Gold Coast Turf Club Ltd acknowledges and respects the privacy of individuals. We advise that the information that you provide on this form is "Personal Information" as defined by the Privacy Act 1998 (the "Act"). This information is being collected for the purposes of processing your membership application, keeping you informed of upcoming events and assisting us in improving our service to you. The intended recipients of the information are Gold Coast Turf Club Ltd and service providers engaged by Gold Coast Turf Club Ltd. The provision of information is voluntary, but if this information is not provided, the Gold Coast Turf Club Ltd may be unable to process your registration or enquiry. You have a right of access to, and alteration of, personal information concerning yourself in accordance with the Act. The information is being collected by Gold Coast Turf Club Ltd and will be held by Gold Coast Turf Club Ltd. Please direct any enquiries you may have in relation to this matter to our Financial Controller.

Total

Option

Membership Application

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