Name *

First Name

Last Name

Date Enrolled *

MM

DD

YYYY

Date Retired

Please do not enter a date if you are still serving

MM

DD

YYYY

N.O.K 1 - Name *

First Name

Last Name

N.O.K 2 - Name

First Name

Last Name

Activities

Fishing

Golf

Scuba Diving

Skydiving

Kayaking

Hiking

Hunting Skills Course

White Water Rafting

Family Event Weekends

Other

Where did you hear about us?

A friend or Colleague

Google

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New Article

Other

MEMBERSHIP RULES *

Membership is available to anyone who is or who has served in any of the forces for New Zealand no matter how long you have served. You promise NOT to use to conduct any fraudulent or business activity or have more than one Member Account at any time.

I have read, understood, and accepted the rules for membership.