Membership 2023/24 Season
South Island Quarter Midget Club
Driver's Name
First Name
Last Name
Driver's Birthday
-
Month
-
Day
Year
Date
Car Number
Contracted Track (Track code that follows your car number)
Caregivers Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
Postal / Zip Code
Membership Fee $20.00
Using the drivers name as the reference, please pay your membership fee to: South Island Quarter Kidz Racing Association 03-0855-0549533-00
I have paid my membership fee for the 2023/24 season.
$20.00 has been paid to the above bank account details
Submit
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