QLD 4x4 Club Membership Renewal Form

MEMBERSHIP RENEWAL

Thank you for choosing to rejoin the Queensland 4x4 Club.

Please complete the following form with your relevant details for our Member Records.

First name *

Last name *

Email address *

Phone number *

Address *

Country *

VEHICLE INFORMATION

Please provide your vehicle make / model & registration number.

Vehicle Make & Model *

Vehicle Registration *

FAMILY / NEXT OF KIN INFORMATION

Please provide your next of kin information.

Partner / Spouse's Name First name *

Partner / Spouse's Surname *

Partner / Spouse's Email address *

Partner / Spouse's Phone No *

Would your partner like their own website user profile and be added to the Club mailing list? *

This will allow your partner to login into the Members Only area of the website and also receive Member Newsletters and emails.

Children Information *

Please include each child's name and date of birth, ie: Child 1 - Name + Date of Birth

Next of Kin First name *

Next of Kin Surname *

Next of Kin Phone No *

SOCIAL MEDIA & PUBLISHING

Privacy Policy

As per the Queensland 4x4 Club websites Privacy Policy:

Your personal information is collected for the purposes of establishing and maintaining our data records and to service our relationship with you. We may use your personal information to facilitate these purposes and related purposes such as:

Internal administration; and
Assist us to identify and inform you of activities conducted by Queensland 4x4 Club and its members that may be of interest to you.

For more information please read
https://www.queensland4x4club.org.au/privacy

Do you consent for your Name / Phone Numbers / Email address to be published in the Club Magazine? *

Yes

No

Name Only

MEMBERSHIP FEES & PAYMENT INFORMATION

Membership Fees are due on the 30th of June annually. When you first join your annual membership is pro-rata with your joining fee. Please select the appropriate fee based on the month you join.

Membership Fee breakdown:

Association Fee: $30.00
Club Fee: $40.00

Please select the payment fee based on the joining month.

Four Wheel Drive Queensland Association

Are you a current financial member of another member club of the Four Wheel Drive Association of Queensland? If you are then the Association fee will be waived and select payment options 3 or 4. [Please note that this will be verified with the Club before your membership is accepted]

I am a member of the following affiliated Four Wheel Drive Queensland Club. *

Yes

No

Please only select Yes if you intend to pay the Association Fee through the other Club that you are a member of. If you will be paying the Association Fee through the Queensland 4x4 Club please select No.

If YES, name of Club *

Please provide the name of the affiliated Four Wheel Drive Queensland Club that you are a current member of.

Annual Membership Fees *

1. Membership Renewal Only $70.00 EFT (includes Association Fees)

2. Membership Renewal Only $70.00 payment via Cash to Treasurer (includes Association Fees)

3. Membership Renewal Only $40.00 payment via EFT (excludes Association Fees)

4. Membership Renewal Only $40.00 payment via Cash to Treasurer (excludes Association Fees)

SELECT THE REJOINING FEE OPTION.
Options 1 & 2 include the Four Wheel Drive Association annual fee.
Options 3 & 4 exclude the Four Wheel Drive Association annual fee.
ONLY SELECT OPTION 3 & 4 if you have made Association annual fee payment via your alternate club.

PLEASE MAKE PAYMENT TO:

Name: Queensland 4x4 Club

BSB: 484-799

Account: 030940763
Bank: Suncorp

User reference: Renew + [your initial and surname] ie: Renew J Smith

Off Canvas Main Menu QLD

Queensland 4x4 Club

QLD 4x4 Club Membership Renewal

Membership Renewal - year commencing 1/07/2023 - 30/06/2024

MEMBERSHIP RENEWAL

Please provide your next of kin information.