Your Name (required): 
Company/Business Name: 
Street Address: 
Postal Address: 
City: 
State: 
Postcode: 
Phone: 
Fax: 
Mobile: 
Sat Phone: 
Email 
Web: 
Membership CategoryCompany/Vessel Member $220 (Inc GST)Individual Member $55 (Inc GST)Associate Member $55 (Inc GST)
Type of OperationCharter Sport Fishing BoatMother Boat – Long Range RoverSeasonal Operation Only Area SpecificRoving Game Fishing QLD/NSW etcAssociation/Club/Business (State Type)Other
Other type of business (pls specify): 
Boat Name: 
Length: 
Beam: 
Owner’s Name: 
GBRMPA Permit Number: 
QFS Permit Number: 

1. I agree to abide by the “Code of Practice’ and the “Mooring Code of Practice” of the Cairns Professional Game Fishing Association Inc. (the “Association”)

2. I acknowledge that except to the extent to which any law prohibits such exclusion, the Association excludes all liability for loss of damage of any kind, however caused, in contact, tort, under any statute or otherwise (including negligence) arising out of or in any way related to my Membership of the Association and/or my use of the Moorings. I hereby release, discharge and forever hold the Association, its officers, employees, servants and agents harmless from all claim actions, suits, demands, damages, interest and costs arising out of or as consequences of my Membership of the Association and/or my use of Moorings and any incidental activity.

3. I hereby indemnify the Association, its officers, employees, servants and agents against all claims for any loss, damage, or injury to any person or property whether caused by the negligent act or wilful act or omission, breach of contract, breach of statutory duty or otherwise of the Association, its officers, employees, servants and agents in connection with my Membership of the Association and/or my use of Moorings, and any incidental activity.
I agree (required)

Full Name: 
Position:OwnerMasterIndividualBusiness
Date: 

By submitting, I hereby apply for Membership of the Cairns Professional Game Fishing Association Inc. and agree to be bound by its Constitution. I understand that this Application does not entitle me to Membership until such time as the Committee has accepted it.