Please make sure you have included: …

    Please make sure you have included:                                TYPES OF MEMBERSHIP AVAILABLE
    ·      Page 2 of this form completed as required
                                                                     FAMILY MEMBERSHIP                                            Southern Go Kart Club Incorporated
    ·   Cheques and money orders for membership made pay-
                                                                     2 adults and dependants under the age of 17 years re-
    able to Southern Go Kart Club Inc.                               siding at the same address who compete at sanctioned
    ·   2 Passport Photos for the Primary Member
                                                                     race meetings, after making application as hereinafter
                                                                     provided (entitled to one (1) vote per adult member).
    ·   1 Passport Photo for each family member. (lack of pho-       We can and do recognisethat there are family situations
    tos will cause for a delay in processing the application until   other than what is listed above. If in doubt please ask.
    they are received).                                              SINGLE MEMBERSHIP
    ·   For membership renewals, 2007 Gate Key                       Any person 17 years or over, who competes at sanc-
                                                                     tioned race meetings may become a Racing Single Mem-
    ·   If no key returned an additional $11 fee applies.            ber of the Club upon making application as hereinafter
    For new members, once your membership has been proc-             provided (entitled to one (1) vote per membership).
    essed you will be forwarded a AKA SA licence application
    Any queries regarding the above, please telephone Kevin          SOCIAL MEMBERSHIP                                            Membership
    Ledwidge 0407 001 190                                            Any person who wishes to be involved with the Club on a
                                                                     Social Member upon making application as hereinafter
                                                                                                                                  Application
    If you are a new member you will need to obtain your li-         provided (entitled to (1) vote if the social member holds
    cence from AKA SA. Once you have your licence an OLT is
    required prior to using the track. Please contact Gary Owen      a position on the Committee or an Official position).
    on 0407 356 911. Your track key will be issued by Gary
    upon completion of OLT. A copy of the AKA rule book will be      Recreational users
    issued by the AKA with your licence.                             For 2008 members who use the tracks facilities for rec-
                                                                     reational driving (non competition) will be required to
                                                                     hold a `D Grade race licence. This must be with you at all
                                                                     times when using the track facilities and produced when
                                                                     requested by officials of the Club.




                                                                              Southern Go Kart Club Incorporated

                                                                              Summer Road
                                                                              Bolivar, South Australia
                                                                              PO Box 2402 Port Adelaide 5015

                                                                              Phone: 0407 356 911 OLT Officer/Gary
                                                                                                                                  South Australia's premier karting
                                                                              Phone: 0407 001 190 Membership/ Kevin               complex
                                                                              Email: kevled@tsn.cc
                                                                                                                                  Phone: 0407 356 911


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                                            Southern Go Kart Club Membership Application

                                                                                                     PLEASE READ CONDITIONS BELOW CAREFULLY.                     Please select one of the payment options listed below.
Primary member details
                                                                                                                                                                 2008 Membership fee $260
Surname                                                         D.O.B

                                                                                             I agree to abide by the Constitution of the Southern Go Kart        Or Social membership $10
First Names
                                                                                             Club, and by-laws or regulations pertaining to it and any direc-    Key Fee                 $11
Address                                                                                      tive request or finding of the duly elected Committee of the
                                                             Postcode                                                                                            Payment Options
                                                                                             Southern Go Kart Club Inc.
Contact Details
                         Home                                                                I agree to encourage and promote the sport of Go-Karting and        Cash
                         Work
                                                                                             to ensure that I exhibit the spirit of sportsmanship and good
                                                                                             fellowship at all times when using the track or club facilities.    Cheque
                         Mobile
                                                                                             I agree that I, my assigns or administrators, may not bring any     Money order
Email                                                                                        action, claim or demand whatsoever as a result of any per-
Racing User?       Yes
                                                                                             sonal injury or damage to property caused by or arising out of
                                        Licence form required?             Yes               the use of a Go-Kart against the Southern Go Kart Club, its
                                                                                                                                                                 Please make all Cheques and Money Orders payable to
          Membership Type               Family                   Single                      duly elected committee, or any club member.
                                                                                                                                                                 Southern Go Kart Club Of South Australia
Current Licence Holder? Yes                      Licence expiry date ..../...../..........   I agree that I, my assigns, agents or administrators, shall in-
                                                                                             demnify and keep indemnified the Southern Go Kart Club, its
    Occupation                                                                               duly elected Committee, or any other club member from any              Credit card options also available (Visa or Mastercard)
                                                                                             action claim or demand whosoever instituted commenced or
    Car Registration/s                                                                                                                                              Single payment$271                (including key fee)
                                                                                             maintained by an person or persons sustaining personal injury
                                                                                             or damage to property while using a Go Kart owned, leased, or                             Or
                                                                                             hired by me or otherwise in my legal custody power of posses-
                                                                                             sion.                                                                  Three consecutive monthly         payments of $95
     Family members details
                                                                                             I agree to carry my identification card on my person at all times      total payment $285       (including key and processing fee)
Surname                                                         D.O.B
                                                                                             when using the track or club facilities and produce the same
                                                                                             on request to any member of the duly elected Committee or
First Names                                                                                  other official appointed by the Committee to make such a re-
                                                                                             quest and to leave the track or club facilities should I not be
                                                                                                                                                                 Credit card Authorisation
Racing user?                      Yes       Licence form required? Yes                       able to produce my identification when requested as above.
Current Licence Holder? Yes                 Licence expiry date ...../...../.......          I confirm that I am over 18 years of age and I have read and        Card Type--Mastercard        Visa
                                                                                             will comply with these conditions and the rules of the Southern
                                                                                             Go Kart Club.                                                       Card Number _______ _______ _______ _______
Surname                                                          D.O.B
                                                                                                                                                                 Expiry Date ____/____
First names
                                                                                                                                                                 Name on card______________________________
Racing User?                    Yes         Licence form required? Yes
                                                                                                                                                                 Card Holders Signature _________________________
Current Licence Holder? Yes                 Licence expiry date ..../...../..........
                                                                                             Signed__________________ Date___________                            I am authorizing Southern Go kart Club to debit my credit
Attach additional sheet for more family members.              Sheet attached                                                                                     card for the amount indicated above.

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