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CMW Application for Prospective Membership


Prospective Membership is open to people over the age of 18. It is free for 12 months or until you qualify as a full member.


To join as a Prospective Member:-


• Read and agree with our Conditions of Membership - CMW Responsibility and Conditions of Membership.
• Enter your details below and hit the Submit button - this will generate an
Application Form.
• Confirm your agreement with our terms and conditions (on the Application
Form).
• Read our Guide to Bushwalking before going on a club trip - CMW Guide to Bushwalking.


Note: Fields in *RED are mandatory.


*Name:                               

*Street Address:       

*Suburb / Town:       

*State:      

*Post Code:              


*Date of Birth:
  < dd/mm/yyyy - Example: 30/06/1985 >

Gender:    


Your Contact Details (Mobile phone required for safety reasons only)

Home Phone:      
Work Phone:       

*Mobile Phone:    Enter "none" if no mobile phone.

*Email Address:     

*Preferred Method of Contact:   


Vehicle details

Registration Number:                        

Vehicle Make:
 



Emergency Contact Details (not a CMW Member)

*Emergency Contact Name:     

*Relationship:   

*Emergency Contact Phone Number(s):     

Emergency Contact Email Address:               


Some optional information about yourself.

Your bushwalking experience (Pick the most appropriate from drop down box):    

Details of any health problems that require special attention:



How did you find out about CMW ?




Click Submit to generate Application Form: