A Bravenet.com Contact Form

New Membership Application - CLUB MIATA VANCOUVER ISLAND

The best upgrade you can add to your Miata is to submit this Application, submit the Membership General Waiver, and send your annual dues to our Treasurer. By completing and submitting this Application, you hereby acknowledge and agree to the terms of Membership in the Constitution and in the Privacy Statement set out by Club Miata Vancouver Island. If you have any questions, please contact any member of our club's Executive or email membership@clubmiata.net.

New Member's Name *

Your Street Address *

Your City and Postal Code *

Your Phone Number *

Email Address *

Co-Pilot's Name

Co-Pilot's Address

MIATA /MX-5 INFO *

How did you hear about our club?

Please print, sign and date the club's General Waiver and attach it to this application. Please save this original document and give it to any member of our Executive. *

We distribute a Club Membership Roster via email to all club members which provides current contact information and Miata details for all current members. Please advise if you want your info published in this Roster. NO, I DO NOT want my information listed in the Roster. Yes, I agree to have my personal and Miata information included in the club Roster.

Members of our club may take pictures of the runs and socials. Please indicate whether you agree to have your picture shared and /or posted on our club website. YES, I allow myself and my car to be in shared or posted photos within the club including the website. NO, DO NOT share or post any pictures of myself or my car. I WILL NOT TAKE PART IN GROUP PHOTOS.