MEMBERSHIP APPLICATION FORM Please enable JavaScript in your browser to complete this form.ONLY ONE MEMBER APPLICATION PER FORM *1 x Member Application Member / Applicant *FirstLastParent / Guardian (If Applicable)FirstLastIf ApplicableEmail *Phone *ID Number *Address *Kart / Bike Number *Team NameIf Applicable - MSR4 Class OnlyMembership Type *Annual Club Membership (Excl. Practice Fee) - R 1,000.00One Event Club Membership (Non-Member) - R 250.00Practice Only - R 0.00Non-Participating Members (Officials, Parents, etc.) - R 0.00Only Full Annual Members have AGM Vote Right. 1 Vote / Member Practice Fees *Annual Practice Fee / Kart - R 2,000.00Annual or One Day Practice Fee (Additional Driver) - R 0.00Practice Fees Compulsory for Annual Participating Club Members.Practice Fees *Annual Practice Fee / Kart - R 2,000.00One Day Practice Fee / Kart - R 250.00Annual or One Day Practice Fee (Additional Driver) - R 0.00Practice Fees Compulsory for Annual Participating Club Members.Driver Type *IndividualAdditional Driver - Existing TeamTeam Principle *Additional Driver to Existing TeamJunior Kart Class / CategoryBambino (5-9 Years) - JUNIORMini Rok U/10 (6-10 Years) - JUNIORMicro Max (7-11 Years) - JUNIORMini Rok (8-13 Years) - JUNIORMini Max (9-13 Years) - JUNIORMini MSR4 (10+ Years) - JUNIORJunior MSR4 (11+ Years) - JUNIORJunior Max (12-15 Years) - JUNIORSenior Kart Class / CategoryOKJ/OKN (14+ Years) - SENIORSenior Max (14+ Years) - SENIORDD2 (15+ Years) - SENIORDD2 Masters (32+ Years) - SENIORSenior MSR4 (17+ Years) - SENIORJunior Bike Class / CategoryMini Moto NR49ccHonda NSF 100ccSenior Bike Class / CategoryHonda CBR 150ccMSA License *Annual MSA License - R 0.00Please visit www.msaonline.co.za to complete MSA Driver Profile and apply for MSA Annual or Once-Off Event License, including payment. MSA License (copy) *One Event MSA License - R 0.00Please visit www.msaonline.co.za to complete MSA Driver Profile and apply for MSA Annual or Once-Off Event License, including payment. Reserved Pits *Annual Member Reserved Pit (Incl. Key) - R 250.00Compulsory - Race EntrantsReserved Pits *One Event Reserved Pit (Excl. Key) - R 0.00Compulsory - Race EntrantsKey Deposit *Annual Practice Only (Key Deposit) - R 50.00Compulsory - Race EntrantsPlease view our Pits Allocation Page 1 and Pits Allocation Page 2 before making your selection. NOTE - Pit Numbers not indicated within Pit Selection Schedules (Annual or Once-Off) have already been selected and booked by other Teams/Individuals. Annual Member Pit Selection *123456789101112131415161718192021222324252627282930313233N1N2N3N4N5N6N7N8N9N10N11N12N13N14N15N16N17N18N19N20N21N22N23N24N25N26N27N28N29N30N31N32N33N34N35N36N37N38N39N40N41N42N43N44N45N46N47N48CompulsoryAnnual Practice Only or One Event Pit Selection123456789101112131415161718192021222324252627282930313233N1N2N3N4N5N6N7N8N9N10N11N12N13N14N15N16N17N18N19N20N21N22N23N24N25N26N27N28N29N30N31N32N33N34N35N36N37N38N39N40N41N42N43N44N45N46N47N48CompulsoryPlease view our Club Indemnity and Club Rules before agreeing below.Policy *Hereby confirm that I have read and accept the Privacy Policy, Club Rules and Club Indemnity.Emergency Contact Name *Emergency Contact Number *TotalR 0.00Payment StatusNot PaidPaidSubmit
