Membership Application

Fill in your details below and submit your application. Our team will review it and be in touch soon.

Your Details

First Name *

Surname *

Email Address *

Phone Number *

First Name*

Last Name*

Address*

Phone Number*

Email*

Date of Birth*

Parent/Guardian (If Youth)

BDECR Membership Number (If Known)

EXCA Membership Number (If Known)

EXCA Division (If Known)

Emergency Contact*

Emergency Contact Phone*

Additional Family Member Name for Family Membership 1

Additional Family Member Name for Family Membership 2

Additional Family Member Name for Family Membership 3

Conditions of Membership*

Evidence of Payment

Associate Membership$20.00/yr

Non-rider/Social

EXCA Membership$45.00/yr

Optional, to be confirmed at time of applying ($45 USD)

Reciprocal Membership$50.00/yr

Full paid member of another EXCA Club

Youth Membership$50.00/yr

An Individual up to 17 years of age. This membership includes 1 associate membership for a parent/ guardian

Open Membership$80.00/yr

An Individual over 18 years of age

Family Membership$150.00/yr

4 Family members living at the same address