Temporary Member Form

This form should be completed for all club trips when a temporary member or visitor participates / attends a Club trip either as a driver, driving his / her own vehicle or as a visitor travelling in a member’s vehicle. The form should be completed and payment made to the club well before the date of the trip. If this is not possible you should submit the completed and signed form to the Trip Leader together with your payment of $15.00 PRIOR to commencement of the trip. This form covers either a single member, or all members of one family.

Trip Name*

Trip Location*

General location in Victoria

Trip Leader*

Temporary Participant*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

johnsmith@gmail.com

Address*

Street Address

Street Address Line 2

SuburbPost Code

State

Known allergies / blood type / other important information

FAMILY MEMBER/s AS PASSENGERS: (Show name and relationship to the temporary member. For children show date of birth, non-dependent children over the age of 18 are required to complete their own Temporary Membership Form)

Family Member 1

Family Member 2

Family Member 3

Family Member 4

Vehicle Details (to match Trip Participant List)

Next of Kin

Name and phone number

My Products

Temporary Member fee

$15.00AUD

Total

$0.00AUD

Credit Card

Please read and acknowledge the items below, then sign.

As a temporary member/visitor you are representing the Suzuki Four Wheel Drive Club of Victoria and as such you are expected to abide by our Rules and By-laws. If you are not familiar with our Rules or By-laws please ask the Trip Leader to explain them to you, or to provide you with a copy to read.
If during the trip you are not confident, or do not wish to attempt any part, it is your responsibility to inform the Trip Leader.
In the event of vehicle recovery, it is the vehicle owner’s responsibility to approve recovery attachment points and, where safe, to perform the attachment.
Safe driving practices must be adhered to at all times.
You agree by signing this form that you are the holder of a Current Driving Licence.
If participating as a Driver on the trip, you agree that your vehicle is insurance to the appropriate level of cover to participate on the trip.
Whilst on this trip you will be covered by the Club’s Public Liability & Personal Accident Insurance.
Visitors may attend no more than 3 trips / events as a Temporary Member / Visitor prior to joining the Club.

I agree to abide by the Rules, Bylaws and/ or Policies of the Suzuki Four Wheel Drive Club of Victoria and also agree to abide by any directions or instructions given to me by the Trip Leader.

Temporary Member Signature*