Request to obtain companion access card
Staff initial:
Member Details
Member Name:
Last Name:
Phone:
Email:
Emergency contact details
Name:
Surname:
Phone:
Email:
Confirmation
I authorise Cockburn ARC to keep a copy of my companion card on record and understand:
The companion access card only allows free entry for one companion when accompanying the member with a valid companion card on file
If the companion access is used when the member is not present, the companion access will automatically be cancelled and will not be reissued. This cancellation will be notified via email
It is my responsibility to ensure the companion card on record is kept up to date. If the companion card is not updated, the companion access will automatically cancel as of the expiry date
The companion card access is not available outside of staff hours.
If my membership has been cancelled, the companion access will no longer be active.
Upload copy of companion card: