Membership renewal and personal information updates for the Wellington Racing Club

 
Membership renewal and personal information updates for the Wellington Racing Club
This information is for:-

Date (dd/month/yyyy)
I wish to renew my membership of the Wellington Racing Club Incorporated as a :
Membership type
Date of birth (only required for "Young" Membership dd/mm/yyyy)
Membership number (if known)
Title (Mr/Mrs/Ms/Miss/Other (Please specify))
Preferred First Name
Initials (required)
Surname (required)
Email address (required)
As a member I wish to purchase units in the annual RACE Inc. Punters club at $20 each (Purchases prior to 1st WRC meeting of the season)
Number of Punters Club Units required
The Club would appreciate any updated information such as changes to address, email or phone numbers etc.
Postal Address (including post code)
Home Phone
Mobile
Work Phone
Employer
Occupation
Email (if changed)
As a member of the Wellington Racing Club, you will be provided with a copy of the clubs annual report. Please indicate if you wish to receive this is electronic format. (A "No" response will ensure you receive a hard copy prior to the club AGM)
Please indicate if you were recommended to join by another Wellington Racing Club Member as they may become eligible for additional benefits
Payment
Credit Card Number (Visa or Mastercard only)
Credit Card expiry date (MM/YY)
Name on Credit Card
Please note that you may phone the WRC on 04 528 9611 to provide your credit card details verbally or to arrange other payment methods
Any additional comments if required
CAPTCHA
captcha
Please enter the letters/numbers above exactly as you see them. Uppercase and Lowercase are important.