* Indicates a Required Field

*Membership Type - If you wish to play tournaments only and NOT become a Glen Iris Tennis Club member then select 'Tournament Signup Only' below.

Membership Type*

Additional Family Members

*Note - Discounts may apply if additonal family members are added above. Upon submission of this form, a second form will appear for you to add family member details. Additional family members are irrelevant for tournament only registrations.

Member Username*

Your Password*

Your Title*

First Name*

Last Name*

Email Address*

Date of Birth*
(dd/mm/yyyy)

Phone Numbers
(home/work/mobile)*

Address*

Address 2

Suburb*

State*

Post Code*

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