Young Driver Development Program

Register Your Interest

Guardian First Name

Guardian Last name

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Driver's First Name

Age of Driver

Driver's Last name

Status of Driver

L Plates

Red P Plates

Green P Plates

Fully Licensed

I have full comprehensive car insurance

I am licensed to drive and not suspended for any reason

I can provide my own vehicle

I give pemisson to Kinglake Ranges Rotary Club to Store my contact details

Is there anything you would like to ask?

Bank details for securing a spot:
Amount: $100 ($50 refund upon completion)

Rotary Club Kinglake Ranges

BSB 633 000

Acct 150 852 879

Ref; DD & name

Thank you!
Once we confirm exact numbers to Murcotts - they will give us the schedule for the day and we will notify all participants.

We will confirm your spot once we have received your deposit.

May 19th, 2024