Subscribe to our Newsletter Stay Connected Sign up to receive email newsletters and special offers from Canberra Southern Cross Club. Name* First Name Last Name Email* Date of Birth* DD MM YYYY Gender*FemaleMaleSuburb* Your Suburb Membership Number*Membership Expiry* DD MM YYYY Expiry Date is MM-YY only so please use 01 for DD field. EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms. Share this:FacebookTwitterPinterestPrint
