Membership Application Form

A Joint initiative of Hope Church 2508 and Helensburgh Stanwell Park Anglican Church

ABN: 27 314 260 797 AMSA: AMSA101262
Mail:       PO Box 210 Helensburgh NSW 2508
Shed:     199A Parkes St Helensburgh 2508
Phone:   0413 401 522

Member Details
Part 1 to be completed by the applicant
Have you any health conditions or are you on any medication that may affect your capacity to safely operate machinery? Please note an honest response in this section may not necessarily affect what you can or cannot do but will improve safety.
Emergency Contact Details
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