Membership/Renewal Form Membership Form 2020-21 Parent/Guardian 1 Name* First Last Parent/Guardian 1 Phone*Parent/Guardian 1 Email Enter Email Confirm Email Club Newsletters, event information & invitations, club discounts etc. will be emailed to this email address.Parent/Guardian 2 Name First Last Parent/Guardian 2 PhoneParent/Guardian 2 Email Enter Email Confirm Email Club Newsletters, event information & invitations, club discounts etc. will be emailed to this email address. Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Billing Address* Same as Home Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are your Multiples born already or are you expecting multiple ?*Expecting MultiplesAlready loving being a parent to MultiplesExpecting MultiplesI'm expecting ?*TwinsTripletsQuadsQuintupletsSextupletsWhat is your Due Date ? Date Format: MM slash DD slash YYYY Do you have other Children ?*YesNoChildren's DetailsThe next questions we ask for your children's details. Please enter each child's details individually, you can enter up to 5 children, if you have more then 5 children please email membership@bmbasouthside.org.au with any other children's details. Please make sure you enter both your multiples and single birth children's details, siblings are always included in all our club events. How many children do you have ?12345Child 1 Name First Last Child 1 GenderFemaleMaleChild 1 Date of Birth Date Format: MM slash DD slash YYYY Is child 1 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 1 ?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherChild 2 Name First Last Child 2 GenderFemaleMaleChild 2 Date of Birth Date Format: MM slash DD slash YYYY Is child 2 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 2 ?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherChild 3 Name First Last Child 3 GenderFemaleMaleChild 3 Date of Birth Date Format: MM slash DD slash YYYY Is child 3 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 3?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherChild 4 Name First Last Child 4 GenderFemaleMaleChild 4 Date of Birth Date Format: MM slash DD slash YYYY Is child 4 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 4 ?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherChild 5 Name First Last Child 5 GenderFemaleMaleChild 5 Date of Birth Date Format: MM slash DD slash YYYY Is child 5 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 5 ?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherChild 6 Name First Last Child 6 GenderFemaleMaleChild 6 Date of Birth Date Format: MM slash DD slash YYYY Is child 6 a multiple ?No - Sibling to multiplesTwinsTripletQuadQuintupletSextupletWhich category of Multiples is Child 6 ?Sibling to MultiplesBoy/Girl TwinsGirl/Girl ID TwinBoy/Boy ID TwinGirl/Girl Fraternal TwinBoy/Boy Fraternal TwinGirl/Girl/Girl ID TripletBoy/Boy/Boy ID TripletGirl/Girl/Girl Fraternal TripletsBoy/Boy/Boy Fraternal TripletsGirl/Girl/Girl Triplet ID Twins + FraternalBoy/Boy/Boy Triplets ID Twins + FraternalGirl/Girl/Boy Triplets ID Girls & Frat BoyBoy/Boy/Girl Triplets ID Boys & Frat GirlGirl/Girl/Boy Triplets FraternalBoy/Boy/Girl Triplets FraternalOtherOther InformationDo you give permission for your Child/Children's birthday to be published in our club newsletter ?*YesNoDetail is displayed in the newsletter with just the Month and John & David Smith 3rd Birthday, the actual date isn't listed. Do you or any of your family members have special needs and require advice/assistance from our special needs contact officer?Our special needs support was set up to support all family members including siblings, parents, grandparents, step kids etc. Anyone within your family, particularly those living with you who may have special needs requirements including those in wheel chairs, with allergies, medical conditions, birth defects, physical or mental disabilities or requirements, ADHD, dietary conditions like diabetes and many many other areas.Our club is a not for profit - completely run by Volunteers - many hands make light work - maybe you can help! Is there anything you can donate/contribute/volunteer your time to your Club? Eg. Professional services, fundraising items.Volunteering for Roles and Events - our club is a not for profit - completely run by Volunteers - many hands make light work - maybe you can help!* Join our Committee Help out at Playgroup Co-Ordinate a club social event Organise a club fundraiser Help out at an expectant parent evening Unfortunately I can't help at this time Please check the boxes below if you are interested in finding out more and someone will be in contact. Lots of support from current committee and life members is given to anyone wanting to help out. Membership FeesPlease select your membership type below. If you have any questions about these fees please email membership@bmbasouthside.org.au Covid-19 Update regarding feesDue to the difficult and unusual circumstances surrounding COVID-19, BMBAS committee have decided to re-structure our membership fees for the period 1st July 2020 to 31st March 2021. During this time, all new and renewing members will be welcomed to renew at a pro-rata rate given there is only 9 months remaining of BMBAS’s membership year. In early April 2020, the club had extended all existing memberships from 1 St April 2020 to 30/06/2020 at no cost to you. This allows all families to access a discounted membership, regardless of if, or how, you have been impacted by the economic changes triggered by the Coronavirus. Our membership options are outlined below - $38.00 - 2020 New Pro-rata Membership - For all new families ( inclusive of $5 joining fee) (Normal fees for full year are $45) - $30.00 - 2020 Renewal Membership – all existing members (Normal fees for full year are $40) - $25.00 - 2020 School Age Multiples - Families must have been a member for 5years + (Normal fees for full year are $30) Membership Options*New Membership COVID Prorata $38 ~ Normally - $45 (Once off $5 joining fee plus $40 annual membership)Renewal Membership COVID Prorata $30 ~ Normally $40School Age Mutliples COVID Prorata $25 ~ Normally $30 (Must have been a member for 5yrs+)Our club offers support to those members who may not be able to cover the membership fee but are looking for support, for any reason you can not afford these fees please email our President on president@bmbasouthside.org.au and they will be happy to make an arrangement directly with you. Multiple Family Support ContributionFull Membership $45$20 Donation$10 Donation$5 Donation$2 DonationUnfortunately I can’t help at the momentFor those that would like to and are in a position to help out other Multiple families, you can make a donation to the Multiple Families Support Fund to help those families who need a little helping hand from time to time. These funds will go towards membership fees, meals or essential items for our families. Coupon CodeLife Coupon Price: -$ 25.00 FIN New Member Coupon Price: -$ 38.00 FIN Renewal Coupon Price: -$ 30.00 FIN SAMS Coupon Price: -$ 25.00 Total $ 0.00 PaymentPayment can be made via PayPal account or by using a credit/debit card through the PayPal system (no account needed). Once you click below on Submit Membership Form you will be re-directed to make payment. If you have a PayPal account you can log in or if not then click on the card option below the login to checkout with a card.