Wide Bay Motor Complex
Membership Application Form
Company Name (if applicable)
Please enter Street Number, Street Name, Suburb and Postcode
Mailing Address (if different from above)
Junior (12 - 17) $25.00 per year
Individual Foundation $250.00
Family Foundation $800.00
Business Gold $1,000.00
Business Silver $750.00
Business Bronze $500.00
I am already a member and my personal details have changed (please provide your membership number in the next field)
I am not ready to be a member, but I would like to receive email updates
General Renewal (if applicable)
Please provide your existing Membership Number
Shirt Size (if applicable - shirts are only included with Foundation memberships)
Terms & Conditions
Click here to read our Terms & Conditions (link TBA)
Do you agree to the Terms & Conditions of Membership?
I confirm that the information given in this form is true, complete and accurate
Once you have submitted your application, click on the PayPal link to pay now. Or if prefer to direct deposit, our bank details are available at the top of the page.
Thank you for your support!
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