Member Registration

Individual or Family

Registration form

Registered

MEMBER ACCESS INFORMATION

Please enter family parent/carer No. 1

* Indicates a mandatory field.

Member Number

Password : *

Password must be minimum 8 characters and contain at lease one lowercase, uppercase, number and non alphanumeric value.

Confirm Password : *

Email Address : *

MEMBER DETAILS

First Name : *

Middle Name :

Last Name : *

Gender : *

Date of Birth : *

Mobile : *

Profile Picture :

Are you of Aboriginal / Torres Strait Islander descent? *

RESIDENTIAL ADDRESS

Address : *

Address :

Suburb : *

Postcode : *

State : *

Country : *

FIM Number :

FIM Expiry :

Is your postal address different to your street address?

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Postal Address

Address :

Suburb :

Postcode :

State :

Country :

EMERGENCY CONTACT DETAILS

Emergency Contact Person : *

Emergency Contact Phone No : *

Relationship : *

INSURANCE INFORMATION

Ambulance Fund / Union :

Policy Number / Union Membership Number :

Expiry Date :

Any medical conditions that may be relevant :

PRIVACY SETTINGS

Motorcycling Australia does not like to inundate our members and riders with excessive marketing material. To opt in, please check the boxes below.

Motorcycling Australia, my State Controlling Body and my club may send me communications about motorcycling including activities, programmes, tickets, and receipts for purchases.

I wish to receive offers from Motorcycling Australia and its partners.

ALREADY A MEMBER ?