Rubicon 4WD Association

*Indicates mandatory field.

Welcome to the Rubicon 4WD Association! We will keep your information confidential and we will not sell or give your information to anyone.

Membership fee: $12.00 (includes club decals)

The Rubicon 4WD Association is a member of the California Association of 4WD Clubs, Inc. (CA4WDC). Per their by-laws, members are highly encouraged to belong to CA4WDC. CA4WDC membership dues are prorated based on the month that they are received.

First Name:*

Last Name:*

Spouse's first name:

Street (mailing) address:*

City:*

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Zip Code:*

Email address:*

Home phone:*

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Cell phone:

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Age:

Vehicle Information:

Year:*

Make, Model:*

Color:*

Upgrades:*

Stock

Modified

License:*

State:*

Emergency Contact Information:

Contact Name:*

Contact Phone:*

Alt. Contact Phone:

Relationship:*

How did you learn about us?*

Membership:

Rubicon 4WDA:*

New member - $12
Renewal - $12

CA4WDC:*

Primary CA4WDC Club (if applicable):

CA4WDC Membership # (if applicable):

Waiver of Liability

NOTE: Answering no to the following question will discontinue the membership process.

Do you understand the risks associated with the sport of off-highway driving? Furthermore, do you understand that personal injury and even death can result from off-highway driving, from exposure to the elements, plant life and animal life, and that you can sustain damage to your vehicle? Do you realize that persons have died from some of the conditions one could find themselves in when while participating in an off-highway event?*

I understand and freely accept all risks.

I understand and do not accept any risk.

By adding my email address to this on-line form, I am indicating my agreement as if it were my signature.

Email address:*