Let's Go Cruisin' Cruiser Application

Subscription Type: (One subscription only - no joint subscriptions)
New Subscription

Renewal Subscription Let's Go Cruisin' Cruiser #: ...............

Expiration Date: ............... / ............... (Month/Year)

Subscriber Details
Name :  
Address :  
Date of Birth : ............... / ............... / ............... Male [   ] Female [   ]
Club(s) Name :
or Individual
Occupation :  
Telephone 1 :  
Telephone 2 :  
Email :  
Current Vehicle(s) :
(make / year / model)

 

 

Parent or Guardian (if applicant under 18)
Name :  
Address :  
Relationship :  
Telephone 1 :  
Telephone 2 :  
Signed :  
Date :  

AGREEMENT AND RELEASE
Consistent with my desire to take personal responsibility for my conduct, individually and as a Cruiser of a Let's Go Cruisin', I agree to abide by the code of conduct and the governing documents and policies of Let's Go Cruisin'. I will refrain from any form of discrimination, harassment, derogatory, illegal, or unethical conduct, and I understand that if I engage in such conduct, I may be responsible to reimburse Let's Go Cruisin', my club or other clubs, or other individuals involved with Let's Go Cruisin', for any damages, losses, or costs resulting from my conduct. Understanding that Let's Go Cruisin' events are conducted by volunteers who cannot be effectively screened or supervised by Let's Go Cruisin'. I release and discharge Let's Go Cruisin', associated clubs, governing bodies, and representatives from any liability for the intentional or negligent acts or omissions of any member or officer of my club or other clubs, or any officer of Let's Go Cruisin'. Enclosed with this application form is my subscription fee.
Signed :  
Date :  

To become a Cruiser, complete this application form and bring it to one of our upcoming cruises or events. Let any of the LGC organisers know that you're ready to join us as a Cruiser and they'll help you get your Cruiser pack right away.
If you cannot make it to an event in the near future, but would still like to join up,
Then mail this application to us at Let's Go Cruisin' P.O. box 289 Mt Martha 3934, together with your cheque or money order for $23.00 [ $20 annual fee + $3 postage ].
We'll send your Cruiser pack right back.

www.letsgocruisin.com.au


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