WANNEROO JUNIOR New Membership

WANNEROO JUNIOR New Membership MOTOCROSS CLUB Renewal

Key number Membership Application Pit Bay #

PARENT / GUARDIAN DETAILS: (if under 18 years of age) Amount paid: $______Csh/Chq/EFT

Surname: Given names: Address: POSTCODE: Phone - home: Mobile nos.: Email address: Occupations: Ambulance policy Name: Number: MWA Official Licence MWA Licence type: First Aid Certificate: Number: Expiry Date: Expiry Date:

I/we acknowledge that as part of my/our membership with WJMC, I/we am/are required to attend 3 Busy Bees each calendar year.

Failure to attend an allocated busy bee will result in a $100 fine and my/our child/children will not be permitted to ride at any event until this fine has been paid.

I/we also acknowledge that this club is run entirely by volunteers. I/we will be available at each event to volunteer as required as a flag marshal and/or for canteen duty or for any other voluntary position that my Official Licence allows. I/we agree that if I/we am/are unable to volunteer as such, then I/we will bring someone with me/us to the event to stand in my/our stead. Failure to provide a person to help with flagging will result in the rider not being permitted to take part in the event.

Ambulance Cover is recommended, but if there is no cover, rest assured that the care your child/children receive if injured will not be compromised, but you might be held liable for any expense involved.

Signature: ______

______RIDER 1 DETAILS

Family name: Given names: Address (if different to above): Age at 1st Jan Date of birth: 2016: Licence expiry MWA Licence No.: date: Licence type: Mini Junior National Recreational Senior National MWA Grade: MWA Race No.: Machine type: Two wheeler Quad Engine Capacity: Machine make: 85cc/150f std Class: 50cc Demo 50cc Auto 65cc wheel 128-150 85cc/150f large wheel 100cc-125 2 stroke U19 2stoke/250 4stroke Quad 90cc / 125cc Quad 90cc Limited Quad 200cc 2 stroke / 300cc 4 stroke Competition ______RIDER 2 DETAILS

Family name: Given names: Address (if different to above): Age at 1st Jan Date of birth: 2016: Licence expiry MWA Licence No.: date: Licence type: Mini Junior National Recreational Senior National MWA Grade: MWA Race No.: Machine type: Two wheeler Quad Engine Capacity: Machine make: 85cc/150f std Class: 50cc Demo 50cc Auto 65cc wheel 128-150 85cc/150f large wheel 100cc-125 2 stroke U19 2stoke/250 4stroke Quad 90cc / 125cc Quad 90cc Limited Quad 200cc 2 stroke / 300cc 4 stroke Competition

______RIDER 3 DETAILS

Family name: Given names: Address (if different to above): Age at 1st Jan Date of birth: 2016: Licence expiry MWA Licence No.: date: Licence type: Mini Junior National Recreational Senior National MWA Grade: MWA Race No.: Machine type: Two wheeler Quad Engine Capacity: Machine make: 85cc/150f std Class: 50cc Demo 50cc Auto 65cc wheel 128-150 85cc/150f large wheel 100cc-125 2 stroke U19 2stoke/250 4stroke Quad 90cc / 125cc Quad 90cc Limited Quad 200cc 2 stroke / 300cc 4 stroke Competition Conditions of Membership - Please Read Carefully

1. 50cc bikes are NOT permitted to practice on the track at the same time as any other bike capacity/class - UNDER ANY CIRCUMSTANCES. 2. I WILL attend a MINIMUM OF THREE “Busy Bees” throughout the season as rostered or negotiated with the Busy Bee Coordinator. If I do not attend these, I understand that I must pay a $100 Busy Bee exemption levy for each busy bee that I miss. In addition, riders will be excluded from racing until fines are paid. 3. I will help out with fundraising or promotional activities when asked. 4. All riders intending to ride at Wanneroo Junior Motorcycle Club, at all events, must be able to provide an official over 16yrs of age to be a Flag Marshal or a Key Official on each race day contested by him/her, for the entire day or for any other voluntary position as requested by Club Officials. 5. I understand that it is a family membership only and I am not permitted to take any guests to ride at the Wanneroo Junior Motorcycle Club, Pinjar Park Circuit. 6. Conduct at the track is governed by the Risk Management Policy, The No Hassle Policy and Individual Official’s Responsibilities. Non compliance with these Policy’s and responsibilities, or actions which put the Club at risk, will be taken to the Executive Committee. Failure to comply can result in suspension or exclusion from the Club. 7. It is each and every Club member’s responsibility as their own Duty of Care to ensure a safe riding environment for themselves, their children and fellow Club members- No TRICKS ALLOWED. 8. It is your Duty Of Care to walk the track and check for danger prior to allowing your child to ride the track. If, in your opinion, a danger is perceived, you have a duty of care to do the following:  DO NOT LET THE CHILD RIDE  IF POSSIBLE, REMOVE THE DANGER  FOLLOW INCIDENT REPORTING PROCEDURES - As per the WJMC Risk Management Policy. 9. All Members will have to produce both a valid MWA licence for the rider and an Officials Licence and First Aid Certificate for the parents/guardian, prior to being issued with a key to the track. 10. No riding is allowed in the pits, the car park or service/access roads under any circumstances. The only exception is where Riding Schools require the Car Park for coaching/training purposes. This will be conducted under strict supervision to ensure the safety of riders and spectators. 11. No club member is permitted to leave the track riding an unlicensed motorcycle. 12. Basic first aid knowledge and a working mobile telephone is required when supervising a rider at Pinjar Park. 13. The gate is to be kept locked at all times during free practice. 14. Full protective clothing is to be worn at all times when riding either in a race or during practice. 15. Membership can be revoked if any of these Club rules are not adhered to. 16. Membership is subject to the WJMC Executive Committee approval. 17. I acknowledge receipt of the WJMC Risk Management Policy and Procedures, which are attached to this document (also are available for download on our website: www.wjmc.org.au) and agree to abide by its rules and regulations. 18. I acknowledge receipt of the permitted practice and key levy which is attached to this document.

INDEMNIFICATION - Each person participating at the Clubs track, or at meeting organised by the above Club, does so solely at his or her own risk. Furthermore, he or she shall in no way hold WANNEROO JUNIOR MOTORCYCLE CLUB organisers, sponsors, officials, or owners of the property in any way responsible for injury, loss or damage to person or property.

I/We, the undersigned, hereby give consent for my son/daughter to be a member of the Wanneroo Junior Motocross Club. I recognise that motor racing can be dangerous and agree to abide by the conditions of WJMC membership. I recognise that membership is non-refundable or transferable.

Name of Parent / Guardian Signature of Parent / Guardian WJMC Club Secretary / Registrar signature

Family club membership $ 200.00 annually (Jan to Dec) $ 200.00 Pit Bay fee (if allocated) $ 20.00 annually (Jan to Dec) Permitted practice (includes key) $ 100.00 annually (Jan to Dec) Busy Bee exemption $ 100.00 per busy bee Optional - attendance at busy bees (3 per year) waives this fee Total payable $ .00 Paid by (EFTPOS not available) Cheque / EFT Cash Bank details BSB - 036 233 Account No.: 116 498 Please use your name as reference

Preferred busy bee dates / / If you do not select dates, then dates on which you need to attend busy bees will be allocated.