CLUB MEMBERSHIP

Complete the form below to be a Club Member

Rockhampton Saloon Car Club Inc.

Club Meetings held bi-monthly or as required (details advised via Facebook and email reminder)

We race and abide by Speedway Australia Racing Rules. They offer insurance and licensing.

Apply online at www.speedwayaustralia.net.au or contact Laurie Storer. Laurie can assist with
registering a car plus applying/renewing/upgrading your license.

If you are requiring a new car number with prefix “RK”, please liaise with Laurie to find out what car numbers are available.

Laurie can be contacted via lauriestorer4x@bigpond.com or by mobile 0428 436 158.

2021-22 Membership Form

Please complete details for every person when applying for Family Membership

Primary Club Member Details

Family Member Details

Family Member One

Family Member Two

Family Member Three

Family Member Four

Membership Details

Please select the "membership type" that best suits your situation.
Direct Debit Details
  • BSB: 124051
  • Account Number: 21696399
  • Account Name: Rockhampton Saloon Car Club Inc.

 

Reference: “SURNAME – 21/22” e.g. SMITH 21/22

File types allowed: Jpeg, JPG, PNG, PDF

Data Collection & Storage

Electronic Signature Agreement

I hereby apply for membership of the Rockhampton Saloon Car Club. I agree to abide by the Rockhampton Saloon Car Club Constitution and the Australian Speedway Race Rules, Regulations and Specifications. I give permission for the club to use photos of myself and race car for promotional purposes.

If applicant is under the age of 18 years of age, a parent or guardian must countersign this form.

Download a Printable Version of our Membership Form

Rockhampton Saloon Car Club Inc.

Postal Address
Contact Number
Contact Email
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