Membership Form 2023

Complete this form and click the “Submit” button at the bottom of this page to apply for membership of Berowra Bushrunners in 2023.

For people joining under a Couples or Family membership category, an application form must be completed for each adult applying to join. Children covered under a Family membership do not need to complete this application form – a separate consent form is required instead.

First Name(required)

Surname(required)

Address(required)

Suburb(required)

Home phone(required)

Mobile(required)

Email(required)

Date of birth (dd-mm-yyyy)(required)

Gender(required)

Male Female

Emergency contact name(required)

Emergency contact no.(required)

Membership period(required)

Full Year (Jan - Dec) Half Year (Post 1 July; half-price)

Names of children covered in this membership

Date Of Birth of Children above

What is your facebook name?(required)

I would like to be on the BBR e-mailing list for updates on handicaps, other club activities and updates

I would like my contact information (email / phone) to be shared with other BBR members

I would like to receive offers from other organisations affiliated with BBR

I have read and agree to the conditions in the Declaration below.(required)

Declaration:

I understand running on road or trail is a potentially hazardous activity which may result in injury, including death. It is my understanding that I assume all risks associated with running in events organised by the Berowra Bushrunners (“BBR”). Having read this waiver, I agree that BBR will not be held liable. I hereby release and discharge BBR and its officers and agents from injuries, including death, damage or loss which may occur as a result of my participation in running events including training. BBR and its officers are not liable for damage or loss to personal property brought to training or events.

Payment instructions
Payment can be made electronically to the club’s bank account, with “Membership” & your surname as reference.

Account Name: Berowra Bush Runners
BSB: 633 000
Account Number: 143 564 565

Payment must be received before your BBR membership application can be accepted.
If joining after July 1, please halve the cost of the full payment.

To order club uniforms, click on this link.