Subiaco Toy Library
New Member Application Form
Primary Contact
First Name:
Surname:
Mobile:
Email:
Second Borrower:
First Name:
Surname:
Mobile:
Email:
Child Name:
Gender:
M
F
Date of Birth:
Child Name:
Gender:
M
F
Date of Birth:
Child Name:
Gender:
M
F
Date of Birth:
Address:
Suburb:
Floreat
Jolimont
Subiaco
Wembley
Wembley Downs
Other or not listed
Pcode
State:
How did you find us?:
Friend
Internet
Member
Neighbour
Newspaper
Other
Playgroup
Previous Member
Conditions of membership
By clicking yes I agree to the conditions of Membership:
WAIVER, RELEASE AND INDEMNITY FOR BICYCLES AND SCOOTERS
By clicking Yes I agree to the Helmet waiver, release and Indemnity for Bicycles and scooters.