2025 MEMBERSHIP FORM

MEMBERSHIP LEVELS

FAMILY MEMBERSHIP1-2 Adults and children

$100.00AUD Family Members

SINGLE COMPETITIVE MEMBERSHIPAll Drivers MUST have Competitive Membership unless part of Family Membership

$50.00AUD Quantity

SINGLE NON-COMPETITIVE MEMBERSHIP Officials, Volunteers, Pit Crew

$25.00AUD Quantity

Postage for Log Books if Required

$2.50AUD Quantity

Total

$0.00AUD

EMERGENCY CONTACT

Let us know who to contact if somethinghappens to you or your family
Name*

First NameLast Name
Phone Number*
AGREEMENTS
CODE OF CONDUCT

The YPDKC and AIDKA Policies must be abided by at all times. The Policies are available online via websites www.ypdkc.com and aidka.com.au
Agree to the Code of Conduct*

I have read, understood and agree to abide by both policies. As a guardian of any registrants under 18 years (and anyone else I'm registering), I have discussed the policies and ensured they understand and agree to abide by them.
USE OF DIGITAL MEDIA

As a member and guardian of YPDKC members listed on this registration form, do you consent that any club affiliated with AIDKA may use any photograph taken in a positive manner for the good of the sport
Digital Media Consent*

I ConsentI do not consent
AMBULANCE COVER

It is compulsary that all members of AIDKA hold a current full ambulance cover or equivalent.
Ambulance Cover Agreement*

I agree and confirm that i/we hold adequate ambulance cover and indemnify YPDKC and AIDKA of any ambulance or transport costs.
Should be Empty:

AGREEMENTS