Fitzroy Fourbies INC Club Registration Form

Driver/vehicle owner name*

First NameLast Name

Phone number *

E-mail:*

Your main email address

Address:*

Street Address

CityState

Post code

4WD INFORMATION:

4wd Make Model Year*

Rego:*

Spouse/Partner Details for Couple Memberships

Full NamePhone Number

Spouse/Partner Email

example@example.com

Emergency contact *

Full Name Phone number

Medical Conditions (if any)

Tell Us A Little About You

High - "I got this"Medium - "I'll be right, but I'll sing out if I need a hand"Low - "Please keep an eye on me"Never engaged 4WD

Anything else you would like to tell us?

DISCLAIMER: “FITZROYFOURBIES INC.” (organisers) are not responsible for your safety. Outdoor activities are inherently dangerous. By accepting our “4WD waiver”, you agree to release “FITZROYFOURBIES INC.” (organisers) any responsibility, liability or claim in law or in equity. If you DO NOT agree to these terms, DO NOT JOIN this 4wd Trip activities. “FITZROYFOURBIES INC.” does not certify or verify the expertise of the “Trip Leaders” and “Organisers”. All “Trip Leaders” and “Organisers” in “FITZROYFOURBIES INC.” are club members/volunteers. They are not accredited in motor vehicle recovery, techniques, nor hold themselves to be such an accredited person. You are responsible for your own safety and vehicle safety with the guidance of the trip leader

All 4WDs must have:
1.      All vehicles must be registered, and drivers must abide by all Govt and State road rules.
2.      Rated recovery gear (basic) and recovery points (front and rear no tow balls).
3.      UHF radios, vehicle handsets or handhelds on channel 21 are recommended.
All members and visitors must.
1.      Obey club Model Rules, By-Laws and trip leader’s instructions or you will be asked to leave the organised event and membership may be revoked.

I agree to the above disclaimer and agree to club Model Rules*

MEMBERSHIP FEES

Membership expires 30/06/2026

Membership Fees

Single $20

Couple $30

Please note kids membership is free under the age of 17

EFT Bank Transfer

Direct Debit Commonwealth Bank

Account: Fitzroy Fourbies Inc

BSB: 064709

Account number: 10831600

Use surname as reference

FITZROY FOURBIES INC PRO-RATA MEMBERSHIP FORM.

Tell Us A Little About You