TASMANIAN ENDURANCE RIDERS CLUB INC. MEMBERSHIP FORM
 is a major sponsor of TERC

2012 Membership Form 
( Option A)1.Fill in all fields, 2.Print Membership Form, 3.Send to TERC PO Box 373 Ulverstone 7315 with cheque or money order or bring it to the event;
Or
(Option B) 1.Fill in all fields, 2.Click Submit button at the bottom of form, 3.   Select the Membership type in the box below and complete the Paypal checkout by clicking the button "Buy Now" and following the instructions. (if you have not used paypal before you can follow the prompts to set up an account). 
Or
(Option C) A hand written form can be found here 
PLEASE NOTE; FAMILY MEMBERSHIP IS Parent(s)/Guardian(s) with kids under 16yrs

 
( Option A)1.Fill in all fields, 2.Print Membership Form, 3.Send to TERC PO Box 373 Ulverstone 7315 with cheque or money order or bring it to the event;
Or
(Option B) 1.Fill in all fields, 2.Click Submit button at the bottom of form, 3.   Select the Membership type in the box below and complete the Paypal checkout by clicking the button "Buy Now" and following the instructions. (if you have not used paypal before you can follow the prompts to set up an account). 
Or
(Option C) A hand written form can be found here
PLEASE NOTE; FAMILY MEMBERSHIP IS Parent(s)/Guardian(s) with kids under 16yrs
Membership type


Please enter your name: 

*                             *Required Field

Please enter your email address:

*

1st Members Name*     

Transponder No.

Date of birth*

Allergies
  

Grade eg. peewee, A grade

Class type

Bike type/cc
Race number requested

2nd Members Name
Transponder No.

Date of Birth
Allergies

Grade eg. peewee, A grade

Class type

Bike type/cc
Race number requested

3rd Members Name
Transponder No.

Date of Birth
Allergies

Grade  eg. peewee, A grade

Class type

Bike type/cc
Race number requested

Residential Address:   * Phone:  *
Postal Address:  * Mobile:
        I/We, (as listed above) wish to join the Tasmanian Endurance riders Club and hereby agree to;
                   1. abide by all the rules and regulations
                   2. Be bound by the club's constitution
                   3. Absolve the club, it's members, office bearers and all officials from any liability that may arise.
I am 18 years or older or I am the parent or legal guardian of the junior member listed above and by signing/ticking the box below I accept all the terms and conditions of membership.
                        I agree:   *   (This box must be checked for the membership to be accepted)  
                                              Full name:  *   
                      (Sign here if sending by mail)
                            I have paid by Paypal:        I have enclosed a cheque/money order:   (Circle if printing)

Please nominate how you would like to help in 2012    (Circle if printing)
TRACK BUILDING: SWEEPING: TRACK SET/PACK UP:  MARSHALL: SCORER: LICENCE TO DRIVE TRUCK:
OTHER:

Click here for a hand written form

form processor supplied by www.tectite.com.