Please fill out all the necessary details. If applicable it is important that the Medication Authority Form is completed and signed.
As a member of RISE – Coffs Harbour you are bound by its governing constitution. A copy of the constitution is available on request.

IMPORTANT INFORMATION – DATA PROTECTION

RISE – Coffs Harbour collects and processes information about members. Under the Data Protection Act 1998 you sign this form giving consent
for your personal and sensitive information to be processed under the rules and safeguards laid down by the 1998 Act. We hold your information
securely and do not share it with Third Parties. We may use your information to contact you regarding RISE Coffs Harbour projects and
initiatives.

Personal Details

Name
Date Of Birth
Name
Date Of Birth
Name
Date Of Birth
Name
Date Of Birth
Address

Emergency Contact Details

Price: $ 30.00
Price: $ 40.00
Price: $ 2.00
A mandatory annual membership fee for guardians/parents is required.

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