To become a Dalziel Club member, please fill in the form below and follow the payment instructions at the bottom of the page. 


Date *
Date
Membership Type *
Please note: included with each membership is one BGS Football scarf
$
Payment *

PAYMENT BY DIRECT DEPOSIT TO:

Dalziel Club

Commonwealth Bank 

BSB: 063145  Acct: 1028 4535

*Please ensure the amount matches the options that you select on the form and include your first initial and surname.