Online Membership form

First Name *

Surname *

Email *

Home address *

Suburb and Post Code *

Phone number *

Date of birth *

Why do you want to join the club? *

Are you interested in the Concessions for classics scheme (C4C) ? *

yes
no

Vehicle 1 – Enter Year, Make, Model, Colour, Body type, Licence Plate and VIN

Will you be adding Vehicle 1 to C4C?

yes
no

Vehicle 2 – Enter Year, Make, Model, Colour, Body type, Licence Plate and VIN

Will you be adding Vehicle 2 to C4C?

yes
no

Vehicle 3 – Enter Year, Make, Model, Colour, Body type, Licence Plate and VIN

Will you be adding Vehicle 3 to C4C?

yes
no

Vehicle 4 – Enter Year, Make, Model, Colour, Body type, Licence Plate and VIN

Will you be adding Vehicle 4 to C4C?

yes
no

Vehicle 5 – Enter Year, Make, Model, Colour, Body type, Licence Plate and VIN

Will you be adding Vehicle 5 to C4C?

yes
no

Membership options *

I hereby agree to abide by the Constitution and Code of conduct of Rumble in Rocko Inc, which are located on the FORMS AND DOCUMENTS page. And agree to make payment of the appropriate membership fees as set forth above on approval of my application. *

Yes
No

Online Membership form

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