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Membership

WBA Membership

1 July 2018 - 30 June 2019 for AUD 70.00

First Name

Last Name

Email

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Membership classification

WBA membership

Is this an Individual or Family membership?

Individual

Family

If a family membership, please list family members here.

Address

Town / Suburb

State

Postcode

Country

Phone (home)

Phone (work)

Mobile phone

Interests

Small boats

Canoes/Kayaks

Trailerable boats

Keel boats

Power boats

Model boats

Type of boat insured

Name of insured boat

Registration number of insured boat

Length (LOA)

Insurance Company

Policy Number

Insure Policy expiry date

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Rules of Association

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