Renewal Form :: The Grassroots' Club – Exclusive Membership Club

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 Type

*Membership will be valid until the end of the 3rd quarter of 2025.

Principle Membership

$60

Principle Membership With Family Membership

$100

PA Staff

$60

PA Staff With Family Membership

$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.