2012 Membership Renewal Form - WA Sporting Car Club

Incorporated 1931
WASCC MEMBER #
Surname
First Names
Date of birth
Wattle Avenue off Old Yanchep Rd Neerabup
Phone 08 9306 8022 Fax 08 9306 8539
E-mail wascc@wascc.asn.au
PO Box 267 Wanneroo WA 6946
ABN 95 077 296 424
2012 Membership Renewal Form
Membership Benefits Expire 31 December 2012 *
MEMBER DETAILS
MEMBERSHIP TYPE REQUIRED*
(See next page for details)
Email Silver Was $260 $160
Address Bronze Was $220 $120
Junior (up to age 16) $60
Suburb Additional Items: @
Postcode Circuit Improvement $50 $
Mobile # Club Keyring $3 $
Business ph Club Sticker $2 $
Home ph Club Badge $6 $
Fax # SUB-TOTAL $
Emergency contact
– name / relationship Credit Card Surcharge ** $
Emergency contact
– phone # TOTAL $
Please indicate your likely use of membership in order that we can provide you with up to date information on what you are
most interested in (Notification of Events May Be Supplied via Email if Email address supplied)
Spectator Only V8 Supercar Round Tuning Days Drift Practice
Drift Battles Hill Climbs Regularities Super Sprints
Burn Out Comps Endurance Events Historic Events Circuit Racing
Competition Driving School
Payment Method: Cash Cheque Money Order (Payable to WA Sporting Car Club)
OR charge this purchase to my credit card (please indicate type) Visa Mastercard Amex Dinners
** credit card surcharges apply at the rate of 2% for Visa & Mastercard, 2.5% for Amex and 2.75% for Diners
Card Number Expiry
Name On Card Signature
Note: Section 27 of the Associations Incorporation Act (1987) sets out that members have the right to access and copy the register of
members containing their postal address or residential address, the association rules and the record of office holders.
PLEASE RETURN THIS APPLICATION TO THE WASCC: DETAILS SHOWN ABOVE
OFFICE USE ONLY:
Only use this form if you
were a member in 2011.
These are the pro rata prices.
Membership Number ___________________ Invoice Number __________________
Date Processed __________________ Date Mailed __________________

*Membership Categories
(Benefits expire 31 December 2012)
Silver Membership
� FREE spectator admission to ALL WA Sporting
Car Club events.
� Access to drive 1 on the circuit in your road car
at club Tuning Days for a nominal fee. 2
� Participation in motor sport as a driver 1 . 2
Minimum level required for CAMS competition
eligibility (additional licence fee applies).
� Discounted entrant fees for participation in race
meetings.
� Voting rights.
� Lively and informative magazine The Racing
Line sent free to members.
� Access to McCrackan House at all WASCC
events.
� FREE WA Sporting Car Club Members’ cap.
� One FREE Private Practice voucher for a
Tuning Day or Drift Practice valued at $60 (not
redeemable for cash)
� Discount tickets to events for family and friends
1 To drive on the circuit a CAMS Licence is required.
2 additional fees apply
Gold Membership
All the benefits of a Silver member PLUS
� Single race car entry to seven club WASCC
race meetings. (no refunds or credits).
� FREE access to all Tuning Days in the
membership year.
Bronze Membership
� FREE spectator admission to ALL WA Sporting
Car Club events.
� Access to McCrackan House at all WA
Sporting Car Club events.
� Cannot compete in any event or noncompetitive
activity such as a Tuning Day or
Drift Practice.
� FREE WA Sporting Car Club membership cap.
� Lively and informative magazine The Racing
Line sent free to members.
Junior Membership
� Junior Membership is for persons up to their
16th birthday.
� Membership card.
� FREE spectator admission to WA Sporting
Car Club events.
� Access to McCrackan House at all WA
Sporting Car Club events.
� Cannot participate in motor sport or drive on
the circuit or Jack's Hill.