Join Us Today

New Member Form

ANNUAL SUBSCRIPTION:
New Members
$45 for the period 1 July 2025 - 30 June 2026
($25 if joining after 1 Jan 2026)

Member Details

* Indicates required field

Primary Member Name *

First

Last

Street Address *

Town / City *

Postcode *

Home Phone *

Mobile *

Email *

Secondary Member Name *

First

Last

Mobile *

Email *

Car Details

Make *

Model *

Year *

Engine *

Reg No. *

Colour *

Additional information *

We will store your personal data securely using the services of an external service provider. Access will be restricted to the Southern Lotus committee. Please provide your consent for us to share your data with our service provider.

Consent to share personal data *

I agree

Indemnity

In consideration of the acceptance of my membership and of my being permitted to take part in Club events, I agree to hold harmless and keep indemnified Southern Lotus, all the owners and tenants of private property traversed by a Club event, Committee members, Club members, fellow entrants, drivers and passengers, servants, representatives, agents and all persons having any connection with the Club from and against all losses, actions, claims, expenses and demands in respect of death, injury, loss or damage to persons or property, to myself, my drivers, passengers or any other persons whatsoever howsoever caused arising out of or in connection with any Club event, notwithstanding that such death, injury, loss or damage may have been contributed to or caused by the negligence of Southern Lotus or any of the Committee, Club members, representatives, agents or by any other person.

The Constitution

I have read the Southern Lotus Constitution and agree to comply with it and any subsequent amendments to the rules.

Acceptance of Indemnity *

I agree

Acceptance of the Constitution *

I agree

Payment Method

Subscription Type *

New Member 12 months (1 Jul - 30 Jun) New Member 6 months (1 Jan - 30 Jun)

Payment Method *

Direct Bank Payment Cash

Direct payment to ANZ Bank Acc No: 11-7901-0193358-11
Include 'New member' in the Reference details.

Cheques will no longer be accepted by our bank. Direct bank transfer payments are now the club's preference, however if this is not possible, please contact the Treasurer to arrange a cash payment. Call 027 432 8018.

Submit