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Renewal Form
Renewal Form
Membership Number
Member's Name
Please attach passport size photo
Email Address
Expiry Date
Family Membership Number (If renewing Family Membership)
I consent to allow The Grassroots’ Club to share my personal details with PA or any other organization to verify my Grassroots Leader status.
Membership Fees
Membership Type
Principle Membership
Principle Membership with Family Membership
Youth Membership (15 - 35 Years old)
Youth Membership with Family
Senior Membership (65 years old and above)
Senior Membership (65 years old and above) with Family
PA Staff
PA Staff with Family Membership
Number of Years
*Kindly Tick the appropriate Membership Years.
Principle Membership
$60
Principle Membership
With Family Membership
$100
Youth (15 to 35 Years old)/Senior (65 Years old & above) Membership
1 Year - $60
Youth (15 to 35 Years old)/Senior (65 Years old & above) Membership
With Family Membership
1 Year - $100
PA Staff
1 Year - $60
PA Staff
With Family Membership
1 Year - $100
Vehicle No.
*Please update if there is any changes in vehicle number and/or IU number.
Car plate Number
IU Number
Please Upload Log card
Spouse Vehicle No.
*Only Applicable if spouse has family membership.
Car plate Number
IU Number
Please Upload Log card
By Checking the following checkbox, you agreed to the following Terms and Conditions below
I, hereby confirm that the above information is true and complete
I consent to allow The Grassroots’ Club to send marketing information about their goods or services including notifying me of their marketing events, initiatives and promotions, lucky draws, membership, rewards schemes and other promotions.
I, agree to comply with and be bound by the Constitution, Bye-laws and Rules & Regulations of the Club.
All membership subscription fees paid for current or advance membership terms are strictly non-refundable for any unused years of subscription upon resignation, termination in any manner whatsoever, changes of membership types or cessation of the Clubhouse and its facilities.
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