Membership Form | Nautilus Scuba Club Cairns

Are you a new or renewing member?*

New Member
Renewing Member

Membership Type*

Ordinary Membership: $90
Junior Membership: $45

Please note that membership runs for the financial year, 1st July through to 30th June, there are no pro-rata payments.
$20.00 Discount if paid BEFORE July 31st.

*Junior Membership - under 16 years old and with an Open Water Certification

Earlybird Discount*

I am paying in July ($20 discount)
I am paying after July

When did you first join the club?*

Before the 1st of January 2022
On or after the 1st of January 2022 ($20 discount)

We offer a $20 discount to members that paid full price for 6 months or less of membership in their first year if they renew in July.

Total

$ 0.00

Personal Details

Name*

First Last

Date of Birth*

Email*

Phone (Home)

Phone (Work)

Phone (Mobile)

Residential Address*

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

Mailing Address (if different)*

Same as previous

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

Diving Qualifications

Certification Level*

Open Water
Advanced
Rescue
Dive Master
Other

Other Certification Level

Certification Agency*

PADI
SSI
NAUI
TDI/SDI
Other

Other Certification Agency

Certification Number*

Number of Dives*

Attach Copy of Certification Card

Only required for New Member applications.

How did you hear about the club?*

Payment Amount

$ 0.00

Payment Details

Note: Please do not pay your membership fees for a new financial year until it has started, ie on or after July the 1st.

In person: by cash or Cheque at the monthly club meeting
By EFT: Bendigo Bank
BSB: 633 000
ACCT: 113625982
ACCT Name: Nautilus Scuba Club Inc.

Please ensure that you include your name as the reference, also email the treasurer at: clubmembership@nautilus-scuba.net to advise of your payment.

Nautilus Club Inc Disclaimer

I acknowledge that in consideration of the acceptance of my application for membership/renewal of membership of the Nautilus Scuba Club Inc by its Committee on behalf of the association of its members and notwithstanding anything contained in the Club Constitution, Club Rules or elsewhere, neither Nautilus Scuba Club Inc, its Committee nor its members shall be liable for any loss, damage or injury however caused at any time, and whether caused by any acts, default or negligence of the Club, its Committee, its members, servants, agents or independent contractors, and that all activities undertaken with the Club shall be entirely at my own risk. As a member of the Nautilus Scuba Club Inc, I agree to the above disclaimer and also to comply with the Nautilus Scuba Club Inc Constitution and Club Rules.

I agree to the above