I hereby submit my Nomination fee if applicable and Annual subscription. The information provided is true and correct, and if accepted, I agree to abide by the Constitution and Rules of the Cockburn Power Boats Club Inc. including VIP requirement. I confirm I do not have any criminal convictions involving violence or offences against children. I also confirm I have not had my membership of any Club or organisation terminated or resigned as a result of, or, to avoid any form of disciplinary issue or action. Please contact the Club if you are unable to confirm the previous statements.