201415 NewMemberForm MRCstaff
2014-15 MEMBERSHIP APPLICATION FORM SAVE TIME AND JOIN ONLINE TODAY AT MRC.NET.AU/MEMBERS PERSONAL DETAILS TITLE:
FIRST NAME:
SURNAME:
DATE OF BIRTH:
ADDRESS: SUBURB:
POSTCODE:
EMAIL: PHONE NO.:
MOBILE NO.:
Has your application for membership of any club been rejected or deferred?
YES
NO
Have you ever been dealt with on any charge by a committee or club?
YES
NO
Have you ever been convicted in court of any offence?
YES
NO
Are you a member of any other racing club?
YES
NO
If so, please state particulars:
If yes, please state which Club:
MRC STAFF PROPOSER DETAIILS TITLE:
FIRST NAME:
SURNAME:
SUBURB:
MEMBER:
YES
NO
MEMBERSHIP No:
REMARKS: SIGNATURE:
SECONDER/ REFEREE DETAILS TITLE:
FIRST NAME:
SURNAME:
SUBURB:
MEMBER:
YES
NO
MEMBERSHIP No:
REMARKS: SIGNATURE: PHONE NO.:
MOBILE NO.:
The information requested above is only used by the Melbourne Racing Club Committee and Membership Department as part of the membership application process, unless otherwise stated. Privacy law safeguards your personal details. You may request to access your personal information which the Club holds by contacting the Membership Department during business hours on (03) 9257 7200.
MEMBERSHIP ENTRANCE FEE MRC MEMBERSHIP
Please state which entrance fee is applicable:
MRC Member $200 / Seniors Card holder* $100 / Registered horse trainer* $100 / Registered horse owner (Gold Card holder)* $100 / Join with a friend (per person) $150 / Family (per person) $150 / Member of another racing club* $150
$ $25
MORNINGTON RACING CLUB MEMBERSHIP
MEMBERSHIP FEE $1 75 (18 MONTHS)
MRC STAFF MEMBERSHIP - 18 MONTHS (REMAINDER OF 2014-15 PLUS FULL 2015-16 SEASON) MRC EVENT MEMBERSHIP (18 - 40 year olds access to Young Member Events)
$100 (PRO RATA)
MORNINGTON RACING CLUB MEMBERSHIP
$100 (PRO RATA)
JUNIOR MEMBERSHIP (Direct debit payment option not available)
$25
CLIP CLOP CLUB MEMBERSHIP (Direct debit payment option not available)
$15
MEMBER’S SIGNATURE:
DATE:
TOTAL AMOUNT:
Declaration: I hereby declare that to the best of my knowledge, information and belief, the answers given to the foregoing questions are true and correct. I further declare that I am fit to become a member of the club and I have not withheld any information likely to affect the decision of the Committee as to my eligibility for membership. I agree to be bound by, and comply with, the terms of the MRC’s Club Rules, its by-laws, the PRIVILEGES terms & conditions and the behavioural protocols. Available at melbourneracingclub.net.au.
2014-15 MEMBERSHIP PAYMENT. Please complete SECTION 1 for IN FULL payment or SECTION 2 for monthly DIRECT DEBIT payment. SECTION 1: IN FULL PAYMENT METHOD:
MASTER CARD
VISA
AMEX
CHEQUE (Payee: MRC)
CASH (Pay in person at Caulfield Racecourse Administration Building, Gate 22)
CARDHOLDERS NAME: CARD NUMBER: CARDHOLDERS SIGNATURE:
* Photocopy of card must be provided as proof
EXPIRY DATE:
CCV NO: DATE:
FIRST NAME:
SURNAME:
DATE OF BIRTH:
ADDRESS: SUBURB:
POSTCODE:
EMAIL: PHONE NO.:
MOBILE NO.:
Has your application for membership of any club been rejected or deferred?
YES
NO
Have you ever been dealt with on any charge by a committee or club?
YES
NO
Have you ever been convicted in court of any offence?
YES
NO
Are you a member of any other racing club?
YES
NO
If so, please state particulars:
If yes, please state which Club:
MRC STAFF PROPOSER DETAIILS TITLE:
FIRST NAME:
SURNAME:
SUBURB:
MEMBER:
YES
NO
MEMBERSHIP No:
REMARKS: SIGNATURE:
SECONDER/ REFEREE DETAILS TITLE:
FIRST NAME:
SURNAME:
SUBURB:
MEMBER:
YES
NO
MEMBERSHIP No:
REMARKS: SIGNATURE: PHONE NO.:
MOBILE NO.:
The information requested above is only used by the Melbourne Racing Club Committee and Membership Department as part of the membership application process, unless otherwise stated. Privacy law safeguards your personal details. You may request to access your personal information which the Club holds by contacting the Membership Department during business hours on (03) 9257 7200.
MEMBERSHIP ENTRANCE FEE MRC MEMBERSHIP
Please state which entrance fee is applicable:
MRC Member $200 / Seniors Card holder* $100 / Registered horse trainer* $100 / Registered horse owner (Gold Card holder)* $100 / Join with a friend (per person) $150 / Family (per person) $150 / Member of another racing club* $150
$ $25
MORNINGTON RACING CLUB MEMBERSHIP
MEMBERSHIP FEE $1 75 (18 MONTHS)
MRC STAFF MEMBERSHIP - 18 MONTHS (REMAINDER OF 2014-15 PLUS FULL 2015-16 SEASON) MRC EVENT MEMBERSHIP (18 - 40 year olds access to Young Member Events)
$100 (PRO RATA)
MORNINGTON RACING CLUB MEMBERSHIP
$100 (PRO RATA)
JUNIOR MEMBERSHIP (Direct debit payment option not available)
$25
CLIP CLOP CLUB MEMBERSHIP (Direct debit payment option not available)
$15
MEMBER’S SIGNATURE:
DATE:
TOTAL AMOUNT:
Declaration: I hereby declare that to the best of my knowledge, information and belief, the answers given to the foregoing questions are true and correct. I further declare that I am fit to become a member of the club and I have not withheld any information likely to affect the decision of the Committee as to my eligibility for membership. I agree to be bound by, and comply with, the terms of the MRC’s Club Rules, its by-laws, the PRIVILEGES terms & conditions and the behavioural protocols. Available at melbourneracingclub.net.au.
2014-15 MEMBERSHIP PAYMENT. Please complete SECTION 1 for IN FULL payment or SECTION 2 for monthly DIRECT DEBIT payment. SECTION 1: IN FULL PAYMENT METHOD:
MASTER CARD
VISA
AMEX
CHEQUE (Payee: MRC)
CASH (Pay in person at Caulfield Racecourse Administration Building, Gate 22)
CARDHOLDERS NAME: CARD NUMBER: CARDHOLDERS SIGNATURE:
* Photocopy of card must be provided as proof
EXPIRY DATE:
CCV NO: DATE:
