Rally NZ Club Inc Membership Form

Full Name *

Email Address *

Mobile Phone *

Postal Address *

City

ZIP / Postal Code

I wish to: *

Apply for a new Membership Renew my MembershipResign

Please acknowledge *

YesNOTES: 1. As a member of the Rally NZ Club Inc I undertake to adhere to the rules of the club. 2.It is a requirement of the Incorporated Societies act; that if you no longer wish to be a member of the Rally NZ Club that you must resign. 3.The membership year runs from 1 Jan to 31 Dec.

I agree to receive emails from the Club *

YesNo

Membership Payment (Non-competing)

Ordinary: Non competitor - $30Fee must be paid to Rally NZ Club Inc ASB Account 12-3233-0608424-00 and proof of payment sent to info@rallynz.org.nz

Membership Payment (Competing)

Ordinary Member: Holds competition license - $50 Fee must be paid to Rally NZ Club Inc ASB Account 12-3233-0608424-00 and proof of payment sent to info@rallynz.org.nz

I hereby apply for membership of the Rally New Zealand Club Incorporated and agree to abide by its rules and regulations.

Gender *

Age range *

Competing or Non Competing *

I wish to: *

Please acknowledge *

I agree to receive emails from the Club *

Membership Payment (Non-competing)

Membership Payment (Competing)