Membership Checkout Membership Information You have selected the Honorary Member membership level. The price for membership is R 0.00 now. Account Information Username Password Show Password Confirm Password Email Address Confirm Email Address Full Name LEAVE THIS BLANK Already have an account? Log in here Family Information (Spouse and Children) Spouse Title Mr. Mrs. Miss. Ms. Dr. Prof. Rev. Adv. Hon. Spouse - Name and Surname Spouse - Date of Birth Spouse - ID Number Spouse - Email Spouse - MSA License No Spouse - Cell No Spouse -Work No Spouse- Fax No Spouse -Home No 1st Child - Name and Surname 1st Child - Date of Birth 1st Child - Gender Boy Girl 1st Child - Contact No 2nd Child - Name and Surname 2nd Child - Date of Birth 2nd Child - Gender Boy Girl 2nd Child - Contact Number 3rd Child - Name and Surname 3rd Child - Date of Birth 3rd Child - Gender Boy Girl 3rd Child - Contact Number Main Member Information Title Mr. Mrs. Miss. Ms. Dr. Prof. Rev. Adv. Hon. Date of Birth Occupation - Industry Type ID Number MSA License No Work No Fax No Home No Membership Starting Date Emergency / Medical Information Medical Aid Name/Scheme - Member Medical Aid Number - Member Medical Aid Name/Scheme - Spouse Medical Aid Number - Spouse Blood Type - Main Member Blood Type - Spouse Any Medical Condition - Member Any Medical Condition - Spouse Emergency Contact Person - Name and Surname If your spouse’s details have already been submitted, please avoid adding them again as your emergency contact and instead provide an additional contact person, in case of emergency where both members (you and your spouse) are involved in an incident. Emergency Contact Person - Phone Number 2nd Emergency Contact Person - Name and Surname If your spouse’s details have already been submitted, please avoid adding them again as your emergency contact and instead provide an additional contact person, in case of emergency where both members (you and your spouse) are involved in an incident. 2nd Emergency Contact - Phone Number Vehicle Information Vehicle 1 - Model 356 911 911 Carrera 911 Carrera S 911 Carrera 4 911 Carrera 4S 911 Targa 911 Turbo 911 Turbo S 911 GT3 911 GT3 RS 911 GT2 911 GT2 RS 911 Speedster 911 R 911 Dakar 911 Sport Classic 912 914 918 Spyder 959 Boxster 718 Boxster Boxster Spyder Cayman 718 Cayman Cayman GT4 Cayman GT4 RS Carrera GT 924 928 944 968 Cayenne Cayenne S Cayenne GTS Cayenne Turbo Cayenne Turbo S Cayenne Coupe Cayenne E-Hybrid Macan Macan S Macan GTS Macan Turbo Panamera Panamera 4 Panamera 4S Panamera GTS Panamera Turbo Panamera Turbo S Panamera Sport Turismo Panamera E-Hybrid Taycan Taycan 4S Taycan GTS Taycan Turbo Taycan Turbo S Taycan Cross Turismo Taycan Sport Turismo Vehicle 1 - Year 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Vehicle 1 - KW To convert HP to KW divide HP value by 0.7457 Vehicle 1 - Colour Vehicle 1 - Tyre Type Standard Semi-Slick Slick Others Vehicle 1 - Weight Vehicle 1 - Registration No. Vehicle 1 - Insurer Vehicle 1 - Has the vehicle been modified or is it standard? Standard Modified Vehicle 1 - Modifications / Notes Vehicle 2 - Model 356 911 911 Carrera 911 Carrera S 911 Carrera 4 911 Carrera 4S 911 Targa 911 Turbo 911 Turbo S 911 GT3 911 GT3 RS 911 GT2 911 GT2 RS 911 Speedster 911 R 911 Dakar 911 Sport Classic 912 914 918 Spyder 959 Boxster 718 Boxster Boxster Spyder Cayman 718 Cayman Cayman GT4 Cayman GT4 RS Carrera GT 924 928 944 968 Cayenne Cayenne S Cayenne GTS Cayenne Turbo Cayenne Turbo S Cayenne Coupe Cayenne E-Hybrid Macan Macan S Macan GTS Macan Turbo Panamera Panamera 4 Panamera 4S Panamera GTS Panamera Turbo Panamera Turbo S Panamera Sport Turismo Panamera E-Hybrid Taycan Taycan 4S Taycan GTS Taycan Turbo Taycan Turbo S Taycan Cross Turismo Taycan Sport Turismo Vehicle 2 - Year 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 Vehicle 2 - KW To convert HP to KW divide HP value by 0.7457 Vehicle 2 - Colour Vehicle 2 - Tyre Type Vehicle 2 - Weight Vehicle 2 - Registration No. Vehicle 2 - Insurer Vehicle 2 - Has the vehicle been modified or is it standard? Vehicle 2 - Modifications / Notes Vehicle 3 - Model 356 911 911 Carrera 911 Carrera S 911 Carrera 4 911 Carrera 4S 911 Targa 911 Turbo 911 Turbo S 911 GT3 911 GT3 RS 911 GT2 911 GT2 RS 911 Speedster 911 R 911 Dakar 911 Sport Classic 912 914 918 Spyder 959 Boxster 718 Boxster Boxster Spyder Cayman 718 Cayman Cayman GT4 Cayman GT4 RS Carrera GT 924 928 944 968 Cayenne Cayenne S Cayenne GTS Cayenne Turbo Cayenne Turbo S Cayenne Coupe Cayenne E-Hybrid Macan Macan S Macan GTS Macan Turbo Panamera Panamera 4 Panamera 4S Panamera GTS Panamera Turbo Panamera Turbo S Panamera Sport Turismo Panamera E-Hybrid Taycan Taycan 4S Taycan GTS Taycan Turbo Taycan Turbo S Taycan Cross Turismo Taycan Sport Turismo Vehicle 3 - Year Vehicle 3 - KW To convert HP to KW divide HP value by 0.7457 Vehicle 3 - Colour Vehicle 3 - Tyre Type Vehicle 3 - Weight Vehicle 3 - Registration No. Vehicle 3 - Insurer Vehicle 3 - Has the vehicle been modified or is it standard? Vehicle 3 - Modifications / Notes Indemnity By updating My Profile I , the undersigned, hereby agree that membership of the Porsche Club of South Africa – Central Region (The Club) is granted on the specific condition that neither The Club nor any of its office bearers shall be liable for any injury, loss or damage of whatsoever nature and howsoever caused, whether due to the negligence of The Club or any of its members or not, whether such damage, injury or loss is sustained on premises used, leased or owned by The Club or not, or whether such damage, injury or loss is sustained during an event organized by The Club or under its auspices or not. I/We hereby accept membership of The Club under the rules as set out in its constitution and the indemnity contained above. I Accept Billing Address First Name Last Name Address 1 Address 2 City State Postal Code Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong S.A.R., China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands US Armed Forces Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Phone Payment Information Card Number Expiration Date 01 02 03 04 05 06 07 08 09 10 11 12 / 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 Security Code (CVC) Processing...
