Membership Form 2023 - Auskart Racing Inc.

Title *

Name *

First

Last

Date of Birth *

Phone *

Email *

Racers License *

classes *

Kart Number *

Please remember if the number you want was being used by someone else last year then you will need a new number. We will email you if there is an issue with your number.

Classes For if your running multiple Classes

Kart Number for second Class

Please remember if the number you want was being used by someone else last year then you will need a new number. We will email you if there is an issue with your number.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Conditions of Membership and Acknowledgement

Conditions Of Membership Signature *

Parent Or Guardian Signature *

Membership Options *

Total *

$ 0.00

Credit Card Payment *

Card

Name on Card

Date / Time

Date

Time