Junior membership is $20 for this type of membership and requires a senior member attached to the membership application.

Please note junior membership is from 15 and under once members turn 16 they will have to purchase a senior membership.

Please fill in the form below for all members as we are upgrading the club’s records.

Please fill in the form below for all members as we are upgrading the club’s records. Date of Birth Required Please follow the instructions below and your membership card/s will be forwarded to you in the mail. You can also download the form and email it through to us, see instructions below.

Junior Membership Details *

First

Last

Email address *

Mobile Number *

Date of Birth *

Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

This address is where your membership card will be sent.

Name of Senior Member *

Must be entered to approve Junior membership. Please refer to clubs T&C'S.

Email address of Senior or Guardian member *

Area of interest SpeedwaySocialMotorcrossTrail RidingOther

Membership Payment

Select your payment type *

• Direct Deposit - $60.00
• Credit Card - $60.00

BSB 633-000 ACC 154202048 For Direct Deposit, please select the option when submitting form. Please make payment to the following bank details using your surname as reference.

Credit Card Payment Details

Card

Name on Card

Submit

If you do not wish to do your membership online fill out this form and post it to PO Box 197, Mildura 3502 with your remittance.