Club Membership Application Membership Fees(Required) R 750.00 per Couple R 450.00 per Single R 400.00 per Junior / Kiddies Bank Details: Africa-Offroad Racing, Nedbank Savings Account No.: 2004513608 Branch Code: 198765Personal DetailsName(Required) First Last ID Number(Required)Postal Address(Required) Postal Address Town / City Province Post Code Contact DetailsWork PhoneHome PhoneCellphone(Required)Email(Required) Preferred Contact Method(Required) SMS Email Facebook Medical DetailsMedical AidMember NumberBlood GroupAllergiesHouse Doctor Name & Contact Number(Required)Emergency Contact Name & Number(Required)Bike, Quad or Car Details & Class to Participate in:Please select the type and enter which class.BikeBike ClassQuadQuad ClassCarCar ClassLicense Type Club License Regional License National License Upload Proof of Payment(Required)Max. file size: 8 MB.Indemnity(Required) I agree to the Indemnity.The Club/Organisers do their utmost to ensure the safety of their Members/ Participants/Spectators, but due to the high speeds attained by Participants, it is impossible to warrant the safety of people/property. For this reason Membership/Right of Admission is only made available to those who accept and understand the danger related to Race Meetings an no claims whatsoever may be held against the Club/Organiser of AORR or the Owner/Landlord of the property, for any damages or injuries to him/her or his/her beneficiaries. I/We the undersigned accept the above and declare that I/We safeguard the Club/Organiser of any such claims.Name & Surname(Required) First Parent / Guardian (If under 21) First Date(Required) DD dash MM dash YYYY
