Season Pass Application

Acceptance

Attention

Personal Details

ALL Individuals Names - First & Last (including children)

Email Address *

Contact Number *

Billing Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *

I hereby apply for Broome Speedway Club Social Membership and/or voting rights. I undertake to be bound by the provisions of the Broome Speedway Club Rules and Regulations.

Name

First

Last

Signature Field

Clear

Product

FAMILY SEASON PASS (No voting rights) (2 Adults and up to 3 Children)

Price: $250.00

Quantity:

SINGLE SEASON PASS (No voting rights)

Price: $100.00

Quantity:

CHILD or PENSIONER SEASON PASS (no voting rights)

Price: $50.00

Quantity:

FINANCIAL MEMBERSHIP INCLUDING AGM VOTING RIGHTS PER ADULT – additional to Season Pass

Price: $20.00

Quantity:

Total

$ 0

Additional Requests

I have read and agree to the Terms and Conditions and Privacy Policy

« Feb 2021 »

Please use Credit card payment option, The paypal opt is not functioning - kurt

Payment Method *

PayPal

Credit Card

« Feb 2021 »