ASKC Membership Form

ALICE SPRINGS KARTING CLUB INC

MEMBERSHIP FORM
For any enquiries please forward them to askartclub@outlook.com

Follow us on Facebook to keep up to date with our racing calendar and any changes throughout the season.

Follow us at https://www.facebook.com/alicespringskartingclub
PRIMARY CONTACT DETAILS
Full Name

First NameLast Name
Mobile
Email Address
example@example.com
Postal Address
I/We agree to abide by Alice Springs Karting Club Inc. Constitution and Code of Conduct*

AGREE
MEMBERSHIP/S
Please select Membership Type/s*

Racing Junior @ $35.00 (Age 15 years or under)Racing Senior @ $65.00 (Age 16 years or older)Racing Family @ $140.00 (2 X Senior & 2 x Junior)Racing Jnr with Affiliate Family @ $100 (2X Junior & 2 x non-racing affiliates)Affiliate Single @ $30.00 (Per non-racing affiliates, note affiliates have voting rights)Life Member @ $0.00 (Person/s awarded Life Membership by ASKC)
DETAILS OF MEMBERS
MEMBER #1 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
MEMBER #2 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
MEMBER #3 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
MEMBER #4 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
MEMBER #5 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
MEMBER #6 - FULL NAME

First NameLast Name
D.O.B
01/01/2024
KART #
If applicable
NEW MEMBERS

Please complete this section for all new memberships, this is not required for renewal applications. Please list 2 names of current members for reference.
Member proposed by:
Full Name
Member seconded by:
Full Name
PAYMENT METHOD
My Products
prevnext( X )
ANNUAL TRACK MAINTENANCE FEE *** Each licensed competitor is required to pay a once-off annual track maintenance fee. Please ensure you select the correct quantities per membership form. ***
$35.00AUD Quantity



RACING JUNIOR 15 years or under
$35.00AUD Quantity



RACING SENIOR 16 years or older
$65.00AUD Quantity



RACING FAMILY2 Juniors & 2 Seniors
$140.00AUD Quantity



RACING JUNIOR W/ AFFILIATE FAMILY2 Juniors & 2 non-racing affiliates
$100.00AUD Quantity



AFFILIATE SINGLENon racing affiliates only
$30.00AUD Quantity



Life MembershipPerson/s awarded Life Membership by ASKC
$ FreeAUD Quantity



Total

$0.00AUD
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty:

ALICE SPRINGS KARTING CLUB INC

PRIMARY CONTACT DETAILS

MEMBERSHIP/S

DETAILS OF MEMBERS

NEW MEMBERS

PAYMENT METHOD