Wide Bay Motor Complex
Membership Application Form
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Email *
First Name *
Last Name *
Company Name (if applicable)
Contact Number *
Address *
Please enter Street Number, Street Name, Suburb and Postcode
Mailing Address (if different from above)
Membership Type *
General Renewal (if applicable)
Please provide your existing Membership Number
Shirt Size (if applicable - shirts are only included with Foundation memberships)
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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 *
What's Next?
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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