YPDKC Membership for the 2024 season

YPDKC Membership for the 2024 season

You will be able to register up to 6 people (including yourself)
Your contact details

We'll start by getting your basic contact details.
Name*

First NameLast Name
Newsletters and club messages will be communicated by email and Facebook (club page or member closed page).
Email*
example@example.com
YesNo
Mobile*
Format: 0000 000-000.
Home phone

Area CodePhone Number
Residential address*

Street Address

Street Address Line 2

SuburbState

Post code
YesNo
Postal address

Street Address

Street Address Line 2

SuburbState

Post code

TOTAL PAYMENT

AUDDescription

Birthdate*

DayMonthYear
Date
Kart number
3 digit number
AIDKA licence number
5 digit number
FAMILY MEMBERSHIP $100SINGLE COMPETIVE MEMBER $50SINGLE NON-COMPETITIVE MEMBER $25
YesNo, just myself

Membership summary

This is a summary of your membership based on your selections. A family membership is $100, competitive singles are $50 and non-competitive singles are $25 each. You won't be charged yet, there are still a few details to collect from you.
If you are registering yourself and 2 or more immediate family members. You are eligible for a family membership ($100).
Family membership Total
Competitive Membership Total
Competitive Quantity
Non-Competitive Membership Total
Non-Competitive Quantity
TOTAL MEMBERSHIP COST

Emergency contact

Let us know who to contact if something happens to you or your family.
Name*

First NameLast Name
Phone*
Format: (00) 0000-0000.

Agreements
Code of conduct

The YPDKCI Code of Conduct Policy must be abided by at all times. The Policy is available as an electronic version or in hard-copy in the Club House Policies Folder.
I have read, understand and agree to abide by the Policy. As guardian of any registrants under 18 years (and anyone else I'm registering), I have discussed the Policy and ensured they understand and agree to abide by it.
Use of digital media

As member and guardian of YPDKC members listed on this registration form, do you consent that any club affliated with AIDKA may use any photograph taken in a positive manner for the good of sport?
I consentI do not consent
Ambulance cover

It is compulsary that all members hold current full ambulance cover or equivalent.
I agree and confirm that I/we hold adequate ambulance cover and indemnify YPDKC of any ambulance or transport costs.

Your contact details