All past players and officials from Fitzroy, Bears, and the are invited to become part of our new-look Association designed exclusively for those who have made a valuable contribution to the Club - both on and off the field - throughout our unique history.

Annual membership is just $20 and includes a range of benefits including:

Free entry into the Members’ Social Club at at 2019 Brisbane Lions home games

Past Players & Officials membership card

Opportunity to promote within the Past Players & Officials Business Directory

Exclusive Past Players & Officials members’ lapel pin

Discounts to select functions throughout the season

CONTACTS AFL Players Association Brisbane Lions Brad Fisher c/ Office P: 03 8850 5600 P: 03 8651 4366 740 Bourke St, Docklands VIC 3008 E: [email protected] E: [email protected] W: lions.com.au/pastplayers c/- Marvel Stadium T: 03 8850 5600 740 Bourke Street, Docklands VIC 3008 E: [email protected]

MEMBERSHIP SELECTION

DESCRIPTION QTY COST/ITEM (INCL GST) SUBTOTAL 2019 Past Player & Officials Membership $20 2019 Historical Society Membership $20 Donation(should you wish to provide one)

TOTAL (INCL GST) $ CLUB HISTORY

Please tick the box/es below that best outlines your past involvement/association with the Club FITZROY (1883-1996) BRISBANE BEARS (1987-96) BRISBANE LIONS (1997-Today) Past player (senior/reserves/U19) Past player (senior/reserves/U19) Past player (senior/reserves/AFLW)

Past Official (please specify below) Past Official (please specify below) Past Official (please specify below)

Official role:

CONTACT DETAILS

NAME

ADDRESS

SUBURB STATE P/CODE

TEL (HOME) MOBILE

EMAIL

I do NOT want my personal details provided to any fellow past players or officials if requested PAYMENT DETAILS

Amex Cheque / Money Order Visa / MasterCard Cash (3% surcharge) (payable to the Brisbane Lions AFC)

Direct transfer: Bank of - BSB: 124 001 - A/C No: 11 271 985 Transfer Date:

Card Number Expiry

Cardholder: Signature: Date:

PRIVACY POLICY: The Brisbane Lions have a Privacy Policy. Where we collect your personal information we will act in accordance with that policy. Please call 07 3335 1777 or email [email protected] to request a copy of our Privacy Policy.