Membership Form

Fields marked with an asterisk (*) are required.

Type of Membership * Family - $30 Single - $25 Club - $60

I would like to make a donation of NZ$

First Name *

Last Name *

Name of other members if a Family membership

Email *

Confirm Email *

Phone

Address line 1 *

Address line 2

City *

Postcode *

Message

ReCaptcha *