Membership Online Application Form


MEMBERS AND APPLICANTS PLEASE NOTE THE FOLLOWING INFORMATION.

You can use our email form below for Membership Application.


Next of Kin information is a requirement of CAMS should there be an incident during a club event.


It is a prerequisite that you hold and maintain CURRENT FINANCIAL STATUS
with the Cobra Car Club for CAMS Insurance purposes.


One membership covers partner plus any children under the age of 18 living at home.


Method of payment:

Cheque payable to: Cobra Car Club (SA)

or

Electronic Funds Transfer to: Bank SA
BSB: 105-900
Account No: 125 212 240
Account Name: Cobra Car Club
Reference: Surname or membership number





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Name:
Address:
Occupation:
Mobile Phone:
Home Phone:
Work Phone:
Email:
Member No:
Newsletter by Email or Post?:
Next of Kin:
Next of Kin Contact:
Cheque or Direct Debit:
Family Members: