Personal Profile Photo Name*
Surname*
Partner Name
Partner Surname
Email*
Mobile Number*
Second Phone Number
Only if available
ID Number*
MSA License Number
Type TBA if not yet renewed
Street Address*
Postal Address
Please ensure this is accurate for postage purposes else you won't get your magazine or membership pack
Medical & ICE Details Medical Aid Company Name
Medical Aid Plan / Type
Membership number
The medical aid number
Contact Phone
The phone number of the medical aid
Your Dr's Name
Your Dr's Phone Number
ICE Contact Name*
ICE (in case of emergency)
ICE Contact Phone Number*
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Show cars if ctype=car OR ctype=NULL Toggle for CarClubs vs Motorrad Clubs, vs Clubs that may offer both ctypes.
Car/s For now we just need to know what your primary vehicle is. Once you have registered you will be able to add more to your profile
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Primary Vehicle*
E.g. E46 M3 GTR, Golf V GTi, Skyline R34 GTR
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Year of Manufacture*
E.g. 1996, 2007
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Engine Capacity*
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Number of Cylinders* Select.. 4 6 8 10
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Aspiration* Select.. Normally Aspirated Turbocharged Supercharged
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Tyre Make*
E.g. Bridgestone, Good Year
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Tyre Type* Select.. Full Slicks Semi Slicks Normal Tyres
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Do you have additional cars to add? This field is hidden when viewing the form
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Vehicle #2
E.g. E46 M3 GTR, Golf V GTi, Skyline R34 GTR
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Year of Manufacture
E.g. 1996, 2007
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Engine Capacity
This field is hidden when viewing the form
Number of Cylinders Select.. 4 6 8 10
This field is hidden when viewing the form
Aspiration Select.. Normally Aspirated Turbocharged Supercharged
This field is hidden when viewing the form
Tyre Make
E.g. Bridgestone, Good Year
This field is hidden when viewing the form
Tyre Type Select.. Full Slicks Semi Slicks Normal Tyres
This field is hidden when viewing the form
This field is hidden when viewing the form
Vehicle #3
E.g. E46 M3 GTR, Golf V GTi, Skyline R34 GTR
This field is hidden when viewing the form
Year of Manufacture
E.g. 1996, 2007
This field is hidden when viewing the form
Engine Capacity
This field is hidden when viewing the form
Number of Cylinders Select.. 4 6 8 10
This field is hidden when viewing the form
Aspiration Select.. Normally Aspirated Turbocharged Supercharged
This field is hidden when viewing the form
Tyre Make
E.g. Bridgestone, Good Year
This field is hidden when viewing the form
Tyre Type Select.. Full Slicks Semi Slicks Normal Tyres
This field is hidden when viewing the form
This field is hidden when viewing the form
Vehicle #4
E.g. E46 M3 GTR, Golf V GTi, Skyline R34 GTR
This field is hidden when viewing the form
Year of Manufacture
E.g. 1996, 2007
This field is hidden when viewing the form
Engine Capacity
This field is hidden when viewing the form
Number of Cylinders Select.. 4 6 8 10
This field is hidden when viewing the form
Aspiration Select.. Normally Aspirated Turbocharged Supercharged
This field is hidden when viewing the form
Tyre Make
E.g. Bridgestone, Good Year
This field is hidden when viewing the form
Tyre Type Select.. Full Slicks Semi Slicks Normal Tyres
This field is hidden when viewing the form
This field is hidden when viewing the form
Vehicle #5
E.g. E46 M3 GTR, Golf V GTi, Skyline R34 GTR
This field is hidden when viewing the form
Year of Manufacture
E.g. 1996, 2007
This field is hidden when viewing the form
Engine Capacity
This field is hidden when viewing the form
Number of Cylinders Select.. 4 6 8 10
This field is hidden when viewing the form
Aspiration Select.. Normally Aspirated Turbocharged Supercharged
This field is hidden when viewing the form
Tyre Make
E.g. Bridgestone, Good Year
This field is hidden when viewing the form
Tyre Type Select.. Full Slicks Semi Slicks Normal Tyres
This field is hidden when viewing the form
Show bikes if ctype=bike OR ctype=NULL Bike/s For now we just need to know what your primary bike is. Once you have registered you will be able to add more to your profile
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Make
E.G BMW
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Model
E.g. R1200GS,K1300S etc
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Year of Manufacture
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Registration Number
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Do you have additional bikes to add? This field is hidden when viewing the form
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Bike #2 Make
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Bike #2 Model
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Bike #2 Year of Manufacture
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Bike #2 Registration Number
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This field is hidden when viewing the form
Bike #3 Make
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Bike #3 Model
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Bike #3 Year of Manufacture
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Bike #3 Registration Number
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This field is hidden when viewing the form
Bike #4 Make
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Bike #4 Model
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Bike #4 Year of Manufacture
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Bike #4 Registration Number
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Section Break General How did you find out about the club? Dealer Other Club Member Web Search Facebook Twitter A Club Event Other (Please Specify)
Please Specify*
Additional Reference, Dealership Name. Club Member Name, etc
Participation in Club events are undertaken on a voluntary basis and at own risk* 
