New Membership Form

NEW MEMBERSHIP DETAILS

Thank you for choosing to join Queensland 4x4 Club.

Please complete the following form with your relevant details for our Member Records.

First name *

Last name *

Email address *

Phone number *

Address *

Country *

VEHICLE INFORMATION

Please provide your vehicle make / model & registration number.

Vehicle Make & Model *

Vehicle Registration *

FAMILY / NEXT OF KIN INFORMATION

Please provide your next of kin information.

Partner / Spouse's Name First name *

Partner / Spouse's Surname *

Partner / Spouse's Email address *

Partner / Spouse's Phone No *

Would your partner like their own website user profile and be added to the Club mailing list? *

This will allow your partner to login into the Members Only area of the website and also receive Member Newsletters and emails.

Children Information *

Please include each child's name and date of birth, ie: Child 1 - Name + Date of Birth

Next of Kin First name *

Next of Kin Surname *

Next of Kin Phone No *

SOCIAL MEDIA & PUBLISHING

Privacy Policy

As per the Queensland 4x4 Club websites Privacy Policy:

Your personal information is collected for the purposes of establishing and maintaining our data records and to service our relationship with you. We may use your personal information to facilitate these purposes and related purposes such as:

Internal administration; and
Assist us to identify and inform you of activities conducted by Queensland 4x4 Club and its members that may be of interest to you.

For more information please read
https://www.queensland4x4club.org.au/privacy

Do you consent for your Name / Phone Numbers / Email address to be published in the Club Magazine? *

Yes

No

Name Only

WEBSITE ACCESS & SOCIAL MEDIA

The QLD 4x4 Club has a Closed Facebook Group page for current Financial Members.

Once your membership has been confirmed you will receive links for:

your website user profile
closed Facebook group page URL to request access
member-only access on the website

How did you find us? *

Website

Google Search

Four Wheel Drive QLD Association

Facebook Page

Instagram

Friend

Family Member

MEMBERSHIP FEES & PAYMENT INFORMATION

Membership Fees are due on the 30th of June annually. When you first join your annual membership is pro-rata with your joining fee. Please select the appropriate fee based on the month you join.

Membership Fee breakdown:

Joining Fee: $65.00 (once off)
Association Fee: $30.00
Club Fee: $40.00

Please select the payment fee based on the joining month.

Four Wheel Drive Queensland Association

Are you a current financial member of another member club of the Four Wheel Drive Association of Queensland? If you are then the Association fee will be waived. [Please note that this will be verified with the Club before your membership is accepted]

I am a member of the following affiliated Four Wheel Drive Queensland Club. *

Yes

No

Please only select Yes if you intend to pay the Association Fee through the other Club that you are a member of. If you will be paying the Association Fee through the Queensland 4x4 Club please select No.

If YES, name of Club *

Please provide the name of the affiliated Four Wheel Drive Queensland Club that you are a current member of.

1. Joining, Association & Membership Fees - Pro Rata *

2. Joining & Membership Fees - Pro Rata (No Association Fees) *

PLEASE MAKE PAYMENT TO:

Name: Queensland 4x4 Club

BSB: 484-799

Account: 030940763
Bank: Suncorp

User reference: New Member + [your initial and surname] ie: New Member J Smith

Off Canvas Main Menu QLD

New Membership Form for QLD 4x4 Club

NEW MEMBERSHIP DETAILS

Please provide your next of kin information.