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Wanganui Stockcar & Speedway Club
2019/2020 Membership Application
Please ensure you complete all sections clearly and in full. Incomplete applications will not be accepted.
All applications are subject to approval by the Committee.
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Email
*
Your email
Name (First, Last)
Your answer
Address
Your answer
Home Phone
Your answer
Mobile Phone
Your answer
Email Address
Your answer
Occupation
Your answer
Next of Kin
Your answer
Next of Kin Contact Number
Your answer
Membership
Double Membership - is for 1 competitor and their partner only. Both members are to complete the membership form.
Social Membership - allows entry to the Clubrooms. You do not have voting rights at the AGM.
Membership
Single Membership $120
Youth Membership $30 + Single Membership $120 (an adult is required to be a full member)
Double Membership $135
Social Membership $30
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Race Class
Your answer
Race Number
Your answer
Payment Method
*
Cheque - Please make payable to Wanganui Stockcar & Speedway Club
Cash
Direct Debit - Please use name and car number as reference - Westpac - Wanganui Stockcar & Speedway Club 03-0791-0434154-00
Membership Sign - My digital signature acknowledges that 1) as a member I do not object to random Drug Testing and 2) as a member I will adhere to the Rules and Regulations as outlined in the Wanganui Stockcar & Speedway Club Incorporated Constitution. You will be asked to sign this form on receipt of your membership card.
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