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Membership
Details
Terms & Conditions
Payment
Confirmation
Your Personal Details
Club
Kaiapoi
First Name
Last Name
Date of Birth
Parent Name
Gender
Male
Female
Email
Password
Confirm Password
Cell Phone
Home Phone
Work Phone
Street
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City
State
Postal Code
Country
New Zealand
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Child Care
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Emergency Contact
Name
Phone
Email
Relationship
Medical Information
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Start Date
First Payment Date
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Membership
Multi Direct Debit Weekly
Price
$23.00 Weekly by Billing
Tag
$20.00
Promotion
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Account Credit
applied after signup
Membership Start Date
Minimum Term
2 months
First Payment Date
Prorated Upfront Fee
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