January 9, 2020 offroad Membership Form Please complete the form below or download and send us a physical form. Personal Details First Aid ---YesNo Vehicle Details Vehicle Class ---Class 1Class 2Class 3Class 4Class 5Class 6Class 7Class 8Class 9Class 10Class CClass Trophy KartsClass KClass UClass S – Modified UTV Fees Full Membership (CORC) $100Social Member (CORC) $25Trophy Karts/Jnr Trucks $50ORANZ Registration $150Change/Additional Class $15Social Member (ORANZ) $25 Payment Method Payment Method ---Internet bankingChequeCash Online Banking Pay using online banking to "Canterbury Off-Road Club" - Account Number 03-1593-0018939-00 Terms and Conditions Membership Fees must be paid by 29th February 2020 to hold your ORANZ number. All racing members must be ORANZ registered, ie. Full Membership (CORC) $100 plus ORANZ Registration $150 = Total $250. As a condition of acceptance of this membership application, I guarantee to further the aims of Canterbury Off-Road Club Inc. during such time as my membership remains current. I acknowledge that this application implies my loyalty to the Club and acceptance of its aims and objectives. I hereby agree to abide by the Constitution of the Canterbury Off-Road Club Inc. Privacy Act consent: I consent to the details contained on this form being held and used by Canterbury Off-Road Club Inc. for the purpose of promoting and running off-road associated events and for all relevant legal and administrative purposes. I acknowledge my right to access and correction of this information. This consent is given in accordance with the Privacy Act 1993. I have read and accept the terms and conditions.