Membership Renewal

Your Details
First Name*
Last Name*
Email*
Phone*
Street Address*
City*
State*
Post Code*
Membership Details
Your membership will expire on the 31st of December, 2019.
Member ID*
Shirt Size*
Any notes
Car Details
Race No.*
CAMS Lic. No.*
CAMS Lic. No. Exp.*
Date Format: DD slash MM slash YYYY
Dorian No.*
Log Book No.*
Payment Details
How would you like to pay?*
- Credit Card - Online
- Direct Debit
- Tailem Bend 2018 Reimbursement*
*Tailem Bend Reimbursement option only for those who competed at the Tailem Bend Round in October 2018, and elect to have their entry reimbursement used for their 2019 Membership Fee.
To complete your payment via direct deposit, please use the following details:

944 Racing Association
BSB: 033 180
ACC: 151 332
2019 Membership Fee*
Price: A$ 200.00
Online Payment Fee*
Price: A$ 0.00
Credit card transactions fees are 1.75% + 30 cents per transaction as per those from our payment gateway provider stripe.com/au. Direct deposit payments carry no transaction fees.
Total
A$ 0.00
Credit Card*

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Disclaimer:

You must read and agree to follow to adhere to race to the guidelines set in the below 944 Challenge Driving Standards Guidelines.

944 Challenge - Driving Standards Document Link
Disclaimer Acknowledgement*
- I have read and agree to oblige by the 944 Challenge Driving Standards Document

Your Details