ASDRA INC Membership Form

Australian Speedway Drivers and Riders Association Incorporated

Please fill out your membership form. Payment must be completed through the linked Square system, at time of submission.
ASDRA Inc

President: Rob Archibald Vice President: Des Alfirevich

Treasurer: Julie Archibald Secretary: Erin Warwick

Committee: Trevor Bell, Brett Schofield, Jack Alfirevich

Email: corriginmotorsportadmin@gmail.com
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of birth
Club Name
Division
Drivers Car Number
Previous ASDRA Membership Number
If applicable
AASA Licence Number
example@example.com
Expiry Date
Please upload a copy of your licence

Cancelof
ASDRA Inc. reserves the right to examine all vehicles. A vehicle registration sticker will be issued once the vehicle has passed examination and all fees are paid.

Driver Member

$75.00 AUD Quantity

Full Member / Pit Crew

$45.00 AUD Quantity

Junior/Associate/Social Member (No voting rights)

$40.00 AUD Quantity

Vehicle Examination / Registration

$45.00 AUD Quantity

Total

MEMBER DECLARATION: (To be read and signed by member).
By payment of the appropriate fees above, I recognise that I am duly bound by the Constitution of ASDRA Inc., their Code of Conduct, Rules and Regulations, all of which I have read and understand. I agree that the continuation of my membership of this club is subject to my compliance at all times with this declaration.
Signature
Should be Empty:

Australian Speedway Drivers and Riders Association Incorporated