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2010

TRURO & DISTRICTS RACEWAY MEMBERSHIP


FORM

SINGLE MEMBERSHIP :- _________ FAMILY MEMBERSHIP:- _________

NAME (S) :- _________________________________________________________


_________________________________________________________________________
_________________________________________________________________________
_______________________________________________________

ADDRESS :- _________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_______________________________________________________

VEHICLE CLASS :- ___________________________________________________

VEHICLE NUMBER:- __________________________________________________

*As a member of TDR, I agree to abide by the clubs rules & regulations and represent
TDR in the highest professional manner at all times.

SIGNATURE:-__________________________________ DATE :- _____________

SIGNATURE:-__________________________________ DATE :- _____________


* Please note that members under the age of 18 must have an accompanying
signature of a parent or legal guardian.

GUARDIANS SIGNATURE :- _______________________ DATE :-____________


-----------------------------------------------------------------------------------------------------
Membership fees :- Single $30 / Family $50

Please send this form to Jannine Vaughan, PO Box 473 Angaston, SA,
5353 with an accompanying cheque or money order, made to Truro &
Districts Raceway inc.

Membership number (secretarial use only) :-_________

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