Membership Application
April 2026 - March 2027
Applicants Details
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Mobile Number
*
Format: (000) 000-0000.
Rider Details
Rider 1 Details
*
First Name
Surname
Rider 1 Class
*
Mini
Junior
Senior
Vet
Rider 2 Details
First Name
Surname
Rider 2 Class
Mini
Junior
Senior
Vet
Rider 3 Details
First Name
Surname
Rider 3 Class
Mini
Junior
Senior
Vet
Rider 4 Details
First Name
Surname
Rider 4 Class
Mini
Junior
Senior
Vet
2026 Club Fees
*
prev
next
( X )
Annual Individual Membership
$
40.00
NZD
Annual Family Membership
Family membership is up to 4 riders. Please complete rider detail fields below.
$
60.00
NZD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Agreement
Please read and acknowledge
*
I/We agree to abide by the rules and regulations of MNZ and those of the Kapi Mana Motorcycle Club.
Date
*
-
Day
-
Month
Year
Date Picker Icon
Submit
Should be Empty: