New Member Application Form

Leederville Toy Library

New Member Application Form

Contact Details

First name: Surname: Email Address: Mobile Number:

Contact Details - Alternative Contact

First name: Surname: Email Address: Mobile Number:

Address:

Street Number and Street Name:

Suburb:

Post Code:

State:

Membership Type:

** There are three membership options (i) standard annual membership at $100/ year plus $50 refundable bond at sign up ($150); (ii) concession annual membership at $50/ year plus $50 refundable bond at sign up ($100) (provide current Health Care Card ID below); or (iii) casual membership at $30/ maximum 20 toy loans, plus $50 refundable bond at signup ($80). Please make the payment using direct debit (we do not take cash) to Leederville Toy (account name), BSB 066-117, account number 00907551, reference: Surname, First name (e.g., SMITH Jane). Please include the same name as entered on your membership.

Select your Membership Type:

Branch Location:

ID Card Number

Membership Information:

** The Library relies on a committee of volunteers. Committee members qualify for free annual membership. If interested in joining the committee, please comment below.

How did you find us?

Language other than English

Comments

Children:

If you have more than 4 children, please email us the details of your fifth and subsequent children.

I don't have any Children.

Child's Full Name:

Gender:

Date of Birth:

Child's Full Name:

Gender:

Date of Birth:

Child's Full Name:

Gender:

Date of Birth:

Child's Full Name:

Gender:

Date of Birth:

Agree and Submit:

I agree to the Terms and Conditions of membership set out by the Leederville Toy Library

I agree to the Code of Conduct and Child Safe Policy set out by the Leederville Toy Library

I agree to the WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS set out by the Leederville Toy Library

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