SPTC Membership Form

Bank details for direct deposit are: SPTC BSB 014513 ACC 109511381 ANZ with your Surname for a reference. Please also supply a copy of your membership form.

First Name*Required	Last Name*Required
Address*Required	Suburb*Required
State*Required	Postcode*Required
Country*Required	Date of Birth Gender
Email Address*Required	Contact Number
OTHER FAMILY MEMBERS
Family Member's Name 1	Date of Birth Gender
Family Member's Name 2	Date of Birth Gender
Family Member's Name 3	Date of Birth Gender
Family Member's Name 4	Date of Birth Gender
MEMBERSHIP FEES
ADULT $35 JUNIOR 14 - 19 $30 KIDS 13 & UNDER $25 FAMILY $50
Enter Word Verification in box below*Required

Please click here for Triathlon Queensland online membership registration