2024-2025 Membership renewal/New member form

2024-2025 Membership renewal/New member form
If you are a regular racer, we encourage you to think about joining the club. Membership benefits include:

Ability to race in all RCRA race meetings
Full voting rights at the club AGM (NOTE: only First 2 adult family/houshold members recive voting rights)
Combination to padlock to gate
Membership fees for the racing season are as follows:

$50 for seniors (16 years of age and older)
$20 for juniors (must be under 16 years of age)
$70 for a family/household (2 senior (voting rights) and unlimited familly living in same household immediate family only)
Name

First NameLast Name
Email
example@example.com
Date of birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.
type of Membership

Senior $50Family household $70Junior $20
Payment Method

PaypalBank Deposit
Payment by direct deposit:

Account Name: Keilor Electric Off Road Car Association Inc.(Bendigo Bank)
BSB:633000
Account Number: 168711430
Make sure you put “MR – Your Name” in the description field

Payment by cash:
Please give your payment to the treasurer or secretary at the track during a club race meet
My Products
prevnext( X )
Senior Membership
$50.00AUD Quantity



Family/Houshold
$70.00AUD Quantity



Junior
$20.00AUD Quantity



Total

$0.00AUD
Family/household membership details

Fill out Bellow
2nd Name (second Voting rights)

First NameLast Name
Birth Date

MonthDayYear
Date
3rd Name (no voting rights)

First NameLast Name
Birth Date

MonthDayYear
Date
4th Name (no voting rights)

First NameLast Name
Birth Date

MonthDayYear
Date
5th Name (no voting rights)

First NameLast Name
Birth Date

MonthDayYear
Date
6th Name (no voting rights)

First NameLast Name
Birth Date

MonthDayYear
Date
Payment Methods

Please click one of the PayPal options to complete payment and submit the form.
Should be Empty:

2024-2025 Membership renewal/New member form

Family/household membership details