Central Coast Dirt Riders

There are 2 ways you can apply to become a member of the CCDR club. You can complete the following online form and send it to a CCDR committee member for approval. With this method, you'll need to print off a copy of your application and send it with a check of $35 to 18 Resthaven Avenue Charmhaven NSW 2263. Alternatively, you can print off and empty application form and bring it to our next event and pay the $35 dollar administration fee in person. Each method is fast and simple!

Please Note: Fields marked was a * need to be completed.

*First Name:		*Last Name:
Nick Name:		*Date of Birth: DD/MM/YYYY	/ /

*Street:		*Suburb:
*State:		*Post Code:

Home:	()	Mobile:
FAX:	()	*Email:	Reveive Newsletter?

Grade:

Sponsor(s):

Registered Rider Number:

Preferred Rider Number:

MA License Number:

Expiry Date:
DD/MM/YYYY

/ /

Preferred Events:
Enduro:	Cross Country:	Grass Track:	Trail Rides:
Sprint:	Short Circuit:	Pony Express:	Moto X:

*Have you already paid the anual membership fee?:

I, the undersigned, heerby make application for membership to the Central Coast Dirt Riders Inc Motorcycle Club. In doing so I undertake to abide by the rules and regulations of the club and the GCR’s as set down by Motorcycling New South Wales. I hereby indemnify the Central Coast Dirt Riders Inc, its officials, committee members or any other persons acting on their behalf against any and all liabilities for death or personal injuries and/or loss of damage caused by negligence or otherwise arising out of my involvement in club meetings or events or activities.