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Mon 16 Feb /
Wine Country Race Day
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Membership Application Form
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Membership Type
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Pro-Rata Membership [$75}
Guest Member Card [$75] (limit one per current member)
Pensioner Member [$75]
5 Year Membership [$990]
Perpetual Membership [$1,500]
Corporate Membership [$3,490]
Student Membership [$75] (current student card required)
Membership Number
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Please enter your Membership Number. Your Guest Card will be added to your existing Membership.
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Name
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Street Address
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Street Address
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Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
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Austria
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Bosnia and Herzegovina
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Bouvet Island
Brazil
British Indian Ocean Territory
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Burkina Faso
Burundi
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Cameroon
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Cayman Islands
Central African Republic
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Nicaragua
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Panama
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Poland
Portugal
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Romania
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Rwanda
Rรฉunion
Saint Barthรฉlemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
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Samoa
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Tรผrkiye
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United States
Uruguay
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Virgin Islands, U.S.
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ร land Islands
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Guest Membership
Please note: There is a limit of one Guest Card per Full Member.
Declaration
*
I hereby declare to the best of my knowledge, information and belief, the answers given are true and correct and that I have not withheld any information likely to affect the decision of the Board of Directors of Newcastle Racecourse as to my eligibility of Membership and I agree to abide by the Terms and Conditions of Newcastle Racecourse for the time being in force.
Consent
*
I confirm I am of legal age โ 18 years or older
Privacy Statement- Newcastle Racecourse advises that the information that you provide on this form is โpersonal informationโ as defined by the Privacy Act 2014. This information is used by Newcastle Racecourse Board of Directors, as part of the Membership approval process. The provision of information is voluntary, but if this information is not provided, Newcastle Racecourse may be unable to process your Membership. You have the right of access to and alteration of, personal information concerning yourself in accordance with the Act. Please direct any enquiries you may have in relation to this matter to Newcastle Racecourse.
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