HVORRA Membership Form 2025

HVORRA Membership Form 2025

Membership Type*

Full Membership - $35

Social - $15

Life Member

MEMBER DETAILS

Surname*

Given Names*

D.O.B*

Street Address*

Town/City*

Postcode*

State*

Home Phone

Mobile*

Email Address*

Occupation

Allergies

Civil Licence No

Motorsport Australia Licence No

Licence Type

Select

RACE CAR DETAILS

Class of vehicle you own

Select

Car No.

Log Book No

Date Log Book Issued

If you own a second car please enter details below:

Class of vehicle you own

Select

Car No.

Log Book No.

Date Log Book Issued

NEXT OF KIN CONTACT DETAILS

Full Name*

Street Address*

Town/City

Postcode

State

Mobile No*

Home Phone

MEMBERSHIP FEE REQUIRED

FULL MEMBERSHIP $35.00 (Full Membership is required for a Motorsport Australia Licence) SOCIAL MEMBERSHIP $15.00 NOTE: Life Members need to fill in this form for the records. BANK DETAILS NAB Hunter Valley Off Road Racing Association BSB: 082 845 Account No: 17328 7441 Please send remittance of payment to g.mbaxter@bigpond.com or attach below.

Please attach remittance

Drag and drop files here or

By ticking the below box and submitting this form, you are confirming that the information above is correct.

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