Waiuku Dirt Track Club Membership 2024/25 Season

*

Membership Renewal

New Member

Name *

Phone *

Drivers License # (if applicable)

Date of Birth (if under 18)

Email Address *

Car Number (leave blank if you don't have one yet)

Class *

Membership *

Social Membership ($45)

Full Membership ($65)

Junior Membership ($45)

I wish to apply for membership to the Waiuku Dirt Track Club & accept that on becoming a member the Management Committee & other members shall require me to abide by the Constitution, Rules & Regulations which govern the functions of the club

Payment can be made through Internet Banking to:

Waiuku Dirt Track Club 02-0476-0086495-00

please include car number and surname as reference, or via EFTPOS/CASH prior to first race meeting

Please tick here if you have paid online *

Yes	No - will pay via eftpos

Junior	4 Cyl Production	4 Cyl Open	6 Cyl Production
6 Cyl Open	8 Cyl	Open Saloons	Fender Benders
Ladies	Mechanics	Leftie Modifieds (open wheel)	Leftie Saloons (closed wheel)
UTV/Off Roader (for forest only)	4WD (for forest only)