Membership Form

Roustabouts RV Club Membership Form
Your Details

Partner details are below
Your Name*

First NameLast Name
Preferred Name*
Address*
Suburb/Town*
Post Code*
Best Phone Number*
Postal Address*
E-mail:*
example@example.com
Emergency Contact Name, other than Spouse or Partner. *

First NameLast Name
Emergency phone Number*
Partner Details
If no partner just insert Nil to questions
Partner Name*

First NameLast Name
Preferred Name
Best Phone Number*
E-mail: Partner
example@example.com
Emergency Contact Name, other than Spouse or Partner, if different to above.*

First NameLast Name
Emergency Contact Number*
Rig Details

(For emergency needs only)
Vehicle Type*
Vehicle Registration No*
Rig*

Caravan (All types)Mobile HomeCamper VanCamper Trailer5th WheelerTouring Equipped RV vehicle with roof tentSimilarly touring equipped RV vehicleSlide On Camper
Rig Style *

On RoadSemi Off RoadOff RoadSelf Contained
Rig Make (Brand)*
Rig Registration No*
Rig Length - 'Feet'*
UHF & HF Radio

UHF radio & flexible antenna required for tagalongs and long paddock drives. HF radio optional
UHF Radio 'Call Sign'*
HF Radio Club Membership*

NilAustravel Safety NetHF Radio ClubVKS737Other
HF (High Freq) Radio 'Call Sign'
Pets

Refer to Club Pet Policy.
Pet Policy*
Type of Pet'*
Nil if no pet
Breed'*
Nil if no pet
No attending events*
Nil if no pet
Certification
Certification & Privacy*

I will comply with the Code of Conduct, Constitution, By-laws, policies and guidelines of the Club.I am aware the Roustabouts RV Club holds Public Liability Insurance.I am aware the Club avails my details to members only and I will do the same.I agree to my photo (or group shot) being used for the promotion of the Club
General Information
How did you hear about the Roustabouts?*
Your Other Caravan Club Membership *
Why do you want to join the club?
Is your main interest in,

Musters (Week Long)Tagalong (3 Week Long)Longer Trips (3+ Weeks Trips)Events & FestivalsAll The Above
What are your three or more Bucket List destinations / events?
Names of known Club members
Enter the message as it's shown*
Should be Empty:

Roustabouts RV Club Membership Form