Gorba - Geelong Off Road Buggy Association

Membership

Membership Type*
Name*
Spouse Name
Child 1
Child 2
Child 3
Child 4
Child 5
Address
Suburb
State
Postcode
Phone (W)
Phone (M)*
Email*
Date Of Birth*
Occupation
Vehicle Class, Engine Size and Race Number
Security Code*
Change Code
Required fields are marked with an asterisk (*)
Geelong Off Road Buggy Association
PO Box 465
Geelong Vic 3220

Membership Types
Full Membership $50
Junior (Under 18 Years competing) $20
Family Membership (Immediate Family at same address) $70
Social Membership (Non-Competition) $20

Please make Cheques or Money Orders payable to:
Geelong Off Road Buggy Association Inc. PO Box 465 Geelong Vic 3220

Or you can pay directly into the following Bank Account:
Bank Commonwealth
Account Name GORBA Inc.
BSB No. 063551
Account No. 00900113

Please send ALL correspondence to GORBA Inc. at PO Box 465 Geelong Vic 3220
or via Email to the GORBA Treasurer at: E: gorba@outlook.com.au