Surname: FOB No:
Address: Home Phone:
Suburb: Work Phone:
Post Code: Mobile:
Please tick if you wish to receive renewal notices or information from GKCV at this email address .
Licence Licence Licence Race Class & No
# First Name Date of Birth Affiliated Club
No expiry grade
Additional Family members (only for Family Memberships):
Part A: New or Renewal Part B: Membership Type
Please tick one Please tick one
New Membership Cadets $190
$135 Rookie $190
Gate FOB Fee
$15 Junior $190
Includes 3 complimentary entry for club day Senior $220
Renewal Membership Family $260
denotes a one time payment for new membership only
Total Fees Due to Club: $
AKA Licence Information: Notes:
1. New or Renewal of Membership or Licence application are
New Licence: Senior/Junior $300 processed via an approved Karting shop.
Cadets/Rookie $300 2. When making payments, two cheques are required.
(a) To "Victorian Karting Association" for Licence payment.
Renewal Licence Senior/Junior $280 (b) To "Go Kart Club of Victoria" for Membership payment.
Cadets/Rookie $280 3. Cash will NOT be accepted.
4. Members of other affiliated clubs please note that no joining fee will
Late payment, after 30days $300 apply if you are a current financial member of another affiliated club.
5. For additional information regarding Membership/Licences or about
the Club, refer to our web site www.gkcv.com.au
Conditions of Membership:
It is a condition of membership that you observe the rules of the Australian Karting Association (AKA) and the Go Kart
Club of Victoria (GKCV) regarding all conduct both on and off the race track. Please be aware that our circuit is
licensed for competition use only and your conduct is in accordance with the competition rules of the association.
Breach of these rules may result in cancellation of your membership and licence.
I have read & understand the GKCV Membership conditions listed above.
Applicant’s Signature:______________________________ Date:_______________