Wagga Wagga 4WD Club Membership Application Form

APPLICATION FOR MEMBERSHIP
Thank you for your interest in joining the Wagga Wagga Four Wheel Drive Club. Your application will be considered by the Committee at their next meeting (1st Tuesday of each month) and you will be contacted shortly thereafter regarding your application.

The information you provide is used for club purposes only and is treated as private and confidential by the club.
Your Information

Mandatory
Application type:*

New Member ($75.00 includes joining fee)Renewal ($65.00)
Your Name*

First Name.Last Name.
MEMBERSHIP NUMBER (Renewal Only)
Membership Number
Email*
example@example.com
Phone*
Primary Phone Number
Postal Address*
Street or PO Box
TownPost Code
Vehicle Details

Mandatory
Make: * Model: * Year: *
Modified?:
Spouse/Partner Information

Optional
Spouse/Partner Name

First NameLast Name
Email Address
e.g. john.citizen@gmail.com
Phone Number
Quick Survey

Mandatory
Where did you hear about the WW4WDC Inc.*

0/50
In a few lines please let the club now what you hope to achieve / gain by joining the WW4WDC Inc.*

0/200
In a few lines, please let the club know if there is anything you may be able to contribute to the WW4WDC Inc.*

0/200
Payment for Application
Membership Fee to be paid by

Direct Deposit (BSB 325185 Account 38701433)
Prior Training Information and Quarry Training Area

Application for Quarry Training Area (QTA) Access for private use available after submission of separate form and approval by the QTA sub committee
Training Area Policy and Conditions on Use
You have read and will abide by the Training Area Policy and Conditions for Use:*

I agree
Please tell us your level of 4WD driving experience:*

No experience (I'm new to 4WD driving)Basic (I have some experience)Experienced (I have been on many 4WD trips)
Please advise us your level of 4WD Training completed*

I have not completed any driver training coursesBasic 4WD Driver TrainingAdvanced 4WD Driver Training"Club" based Training
Media Consent
By not ticking the below option / options you will AUTOMATICALLY be providing your consent to grant the WW4WDC the right and permission to use your name, likeness, and voice, in all types of advertising and promotional or educational materials. This right and permission includes photographs, video recordings, audio recordings, and all other media in which your name, likeness, or voice may be reproduced. This may include, but is not limited to, the clubs website, social media pages and website.
Your Consent

I do not consent to my name, likeness, and voice being used by the WW4WDC
Your Spouse/Partners Consent

My spouse/partner does not consent to their name, likeness, and voice being used by the WW4WDCNo spouse/partner listed
TrackChat Newsletter

Receive via email
Terms and Conditions
1. I understand that 4WD driving is sometimes unpredictable and capable of inflicting serious personal injury or death as well as extensive property damage.
2. I understand that attendance and participation in 4WD activities is not without risk to myself, to members of my family, to my guests or others that may be attendance or to spectators.
3. I understand that any incident involving myself, the location, or actions of other participants or spectators will be my sole responsibility.
4. I agree to assume all risks including, but not limited to, the finanical responsibility of any possible litigation arising from any incident which I may be involved.
5. I expressly accept the risk of any damage or injury while attending or participating in any Wagga Wagga Four Wheel Drive Inc trip, social event, function or other activity as a result of any action by myself, my family or my guests.
6. If my application is approved I grant the WW4WDC permission to publish my name, phone number and email address on the official Club Member List and understand this information may be provided to members from time to time for club related purposes only.
7. I have read and will abide by the club Code of Conduct.
I have read, understood and agree to the Terms and Conditions of membership.
Please verify that you are human*
Membership Number
Payment Date

MonthDayYear
Date
Email/Card
Should be Empty:

APPLICATION FOR MEMBERSHIP

Your Information

Vehicle Details

Spouse/Partner Information

Quick Survey

Payment for Application

Prior Training Information and Quarry Training Area

Media Consent

Terms and Conditions