Bucket Racing NZ - Full Membership Form

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Application form for full club Membership.
This membership is not complete until confirmed by an authorised delegate of the club.

Note, you don't need to sign in to google to complete this, that only applies if you want to save the progress but the format is a little misleading.

Email *

First Name *

Last Name *

Street Address *

City *

Postcode *

Phone Number *

Your Date of Birth

YYYY

Payment *

Full Membership is $40 for the membership year, which starts 1st July each year.

If you are joining as a family (same house) then please have each person fill out the form and add notes saying who you are joining with. It’s $40 for the first and $20 for subsequent members.

If Joining for the first time, or rejoining after an absence, BETWEEN 1 APRIL AND 30 JUNE, for $50 you get the remainder of the current year, plus the next year. This is called a forwarded membership. For a forwarded family membership, the fee is $50 for the first family member, then $30 for all others.

Note: This is NOT available to current members rejoining, and is NOT AVAILABLE BEFORE 1 APRIL OR AFTER 30 JUNE
PLEASE READ THIS AGAIN

Bank Transfer (Please put your name and the word SUBS as reference) Account: is 12-3478-0061498-00 If your bank demands an account name, it's: "Bucket Racing New Zealand Incorporation"

Any notes or info that might be relevant to this application.

Membership Renewal/Application Indemnification and Declaration

I hereby apply for membership/renewal to BUCKET RACING NEW ZEALAND INC. I undertake to abide by the rules of the Club and to pay subscriptions and dues levied by it. I acknowledge the Club’s right to refuse my membership on any grounds and that membership can only be terminated by formal advice in writing. The Club’s financial year ends 31st March, but the membership year ends 30th June.

I consent to the collection of the above details by Bucket Racing New Zealand Inc. for the purpose of membership record and for Bucket Racing New Zealand to retain and disclose these to Motorcycling New Zealand (MNZ), funding agencies and sponsors.

I acknowledge my rights to access and correction of this information. This consent is given in accordance with the Privacy Act 1993.

I HEREBY AGREE to fully indemnify the associations known as Bucket Racing New Zealand Inc, MNZ, Fédération Internationale de Motocyclisme (FIM), Fédération Internationale de l'Automobile (FIA) (and its Karting Commission CIK), MotorSport New Zealand, KartSport New Zealand, Kartsport Wellington, Kartsport Taranaki, Kartsport Nelson, Kartsport Hawkes Bay, The Upper Hutt Council, Wellington Regional Council, all sponsors and all or any members, officials or assistants of any of the above named and or known organisations, their respective servants, officials, representatives, or agents against any injury or accident to myself or damage to my bike or equipment whether in practice or competition. Minors (under 18) must have a parent or guardian’s signature approving conditions of entry and a parent or guardian must be present during racing or practice and to represent a minor at a judicial hearing.

I agree

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