MEMBERSHIP APPLICATION Name * First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Message * Date of Birth * MM DD YYYY Referred By: * Type of Membership * Check One Social Membership: $3200 for 12 months Founder: $5500 for 12 months Winter Membership (November - April): $2000 for 6 months Summer Membership (May - October): $2000 for 6 months Corporate Group Rate All Membership is by invitation only. Members must be age 21 or older. All guests must be age 18 or older, except Cars & Coffee, family events or with prior authorization in special circumstances. Membership may be cancelled at discretion of Fuel Social Club for inappropriate behavior or repeated violation of rules. General Membership benefits are posted and may be modified from time to time to meet Member needs, use and preferences. The undersigned hereby applies for the above-indicated Membership and agrees that my permitted guests and I will comply with all Fuel Social Club rules. Upon approval of my Membership, I authorize Fuel Social Club to charge the credit card account below unless payment is submitted by check with this application. I also authorize renewal dues to be charged to the credit card below unless I notify Fuel Social Club that I do not desire to renew membership prior to my renewal date. Thank you for your submission! Someone from Fuel Social Club will contact you with in 48 hours! Race ON!!!
