Individual Registration

Please enter information in the form below to process registration for event Membership 2025.

Membership Type *

First Aid Qualified ? *

Yes

What Qualifications ? *

Membership Category *

AIDKA License No. *

Transponder Number (s) *

First Name *

Last Name *

Date Of Birth *

Occupation *

Address *

City *

Post Code *

State

Phone *

Email *

How many karts are you registering? *

Kart No. - 1 *

Kart 1 Class *

Kart No. - 2 *

Kart 2 - Class *

Kart No. - 3 *

Kart 3 Class *

Kart No. - 4 *

Kart 4 Class *

Do you have Ambulance cover? *

Yes

Amount

Payment Method

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*