Mairangi Bay Surf Club
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EM Development.

New Registration

PLEASE NOTE : All Junior Age Groups are now full (7-13yrs) - no new registrations will be accepted for Junior Club.

Use this form to register your family with the club. If your family is already registered with the club and you want to re-register for the current season (2009/2010), visit the Current Season Registration page (you will need to login first).
Family Name
Name used to identify the family (e.g. McLeod Family). Maximum 150 characters.
Family Login Details
Username
Username used to login to this website. Must be between 5 and 10 characters long. Maximum 10 characters.
Password
Password used to login to this website. Must be between 5 and 10 characters long. Maximum 10 characters.
Confirm Password
Maximum 10 characters.
Family Contact Details
Main Contact Name
The name of the main contact in the family to use for correspondance. Maximum 150 characters.
Email Address
Main contact email address for the family. Maximum 150 characters.
Alternate Email Address
Alternate contact email address for the family. All emails will be sent to both email addresses. Maximum 150 characters.
Home Phone Number
Maximum 50 characters.
Mobile Number
Main contact phone numbers for the family. Maximum 50 characters.
Family Postal Address
Street Address
Maximum 150 characters.
Suburb
Maximum 150 characters.
City
Maximum 150 characters.
Post Code
Maximum 4 characters.
Emergency Contact Details
Emergency Contact Name
Maximum 150 characters.
Emergency Contact Phone Number
Maximum 50 characters.
Privacy Details
Include in Member Search?
Indicates whether the family members can be found within the member search by other club members.
Read & Accepted the Privacy Policy and Fair Play?
Indicates whether you have read and agree with the club privacy policy.