Senior membership is $40 for this type of membership.

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

Name *

First

Last

Email address *

Date of Birth *

Mobile Number *

Postal Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Where you would like your membership card to be sent.

Any additional info you would like us to know?

Area of interest SpeedwaySocialMotorcrossTrail RidingOther

Membership Payment

Select your payment type

• Direct Deposit - $40.00
• Credit Card - $40.00

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.