New Members

In addition to payment, New Club Members please fill out the informational form below.
A free Name Tag is included with each membership!

New Member Information

First Name

Last Name

Email Address

Street Address

Street Address Line 2

City

State/Province

Postal / Zip code

Phone

What are your interests for this club?

Meet & Greet

Day Drive

Multi-Day Drive

Drive Host

Autocross (Not Club Sanctioned)

Track Day (Not Club Sanctioned)

Other (describe in next question)

Tell us about your car, and anything else you'd like us to know

How did you discover us?

Name Tag Information

(Enter a 2nd Member name only if two name tags are desired.)

Name as you want it to apear

Line 2 (optional, 20 char max.)

2nd Member Name as you want it to appear

Consent for Club Directory
Check the boxes below (any or none) for information you wish to include in our Club Directory, which is shared with other members.
Club Directory participation is OPTIONAL, but if you wish to be included we need Name and Email at minimum.

Share these in the Club Directory (Optional)

All of the following

Name*

Email*

Address

Phone

Car Info

Interests

Thank you for your interest. When membership payment is received, we will send a confirming email.

*Name Tags are free to new members.
**If you are a existing member and wish to purchase a replacement Name Tag, the cost is $12.95. Follow this link to fill out a new Name Tag order form for existing members.

peaktopeakmiata@gmail.com

Events

Membership

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New Members

In addition to payment, New Club Members please fill out the informational form below. A free Name Tag is included with each membership!

New Member Information

*Name Tags are free to new members. **If you are a existing member and wish to purchase a replacement Name Tag, the cost is $12.95. Follow this link to fill out a new Name Tag order form for existing members.

In addition to payment, New Club Members please fill out the informational form below.
A free Name Tag is included with each membership!

*Name Tags are free to new members.
**If you are a existing member and wish to purchase a replacement Name Tag, the cost is $12.95. Follow this link to fill out a new Name Tag order form for existing members.