Membership Form Membership Form - v2 New Member * Yes (joining fee of $10) No Racing * Non Racing 1/2 Year ($10) Non Racing Full Year ($20) Racing 1/2 Year ($30) Racing Full Year ($60) * To be eligible for RED PLATE you must be a full time member (no half yearly) RED Plate Full Year ($60) Family Membership Family Membership 1/2 Year ($30) Family Membership Full Year ($60) Allows up to 3 additional family members Name * First Name Name * Last Name Date of Birth * Email Address Phone Number * Current Ambulance Membership * Yes No Address * Suburb * Postcode * MA Licence Number * MA Licence Expiry Date * Next of Kin * Next of Kin Contact Number * Family Member Name * First Name Name * Last Name Relationship with Primary Member * Father Mother Brother Sister Family Member Name First Name Name Last Name Relationship with Primary Member Father Mother Brother Sister Family Member Name First Name Name Last Name Relationship with Primary Member Father Mother Brother Sister Membership Fee Total ($AUD) Securely PAY by Credit Card If you are human, leave this field blank.
