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  • Anniversary Rally 2011 Entry Form

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    lohengrin
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    ENTRY form ONE per person. Add $5 per night for payments after 17th October. On the day will incur a further 1x$10 fee. By signing this form and / or entering the rally site, I hereby agree to abide by the RULES and REGULATIONS covering this event.

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    ENTRY form ONE per person. Add $5 per night for payments after 17th October. On the day will incur a further 1x$10 fee. By signing this form and / or entering the rally site, I hereby agree to abide by the RULES and REGULATIONS covering this event.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    6 tayangan1 halaman

    Anniversary Rally 2011 Entry Form

    Diunggah oleh

    lohengrin
    ENTRY form ONE per person. Add $5 per night for payments after 17th October. On the day will incur a further 1x$10 fee. By signing this form and / or entering the rally site, I hereby agree to abide by the RULES and REGULATIONS covering this event.

    Hak Cipta:

    Attribution Non-Commercial (BY-NC)
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 1

    Anniversary Rally

    2011

    November 4th 5th 6th 2011 Camp Kaitoke Upper Hutt


    ENTRY FORM ONE PER PERSON

    Name: .....................................................................................................................................................
    Address:

    ................................................................................................................................................

    Email address: ........................................................................................................................................


    Contact phone number : .........................................................................................................................
    In Case of Emergency Contact details:.....................................................................................................
    Bike Registration: ........................................
    Please tick the appropriate Boxes:
    Add $5 per night for payments after 17th October. On the day will incur a further 1x$10 fee.

    Friday night per person

    $45.00

    Bunk (limited to first 60)

    Saturday night per person $45.00

    Tent site

    Two nights per person

    $80.00

    Kayaking

    Extra badge

    $10.00 each

    Horse riding $10.00 per person

    $10.00 per person

    (limited to12 per 2hr session if enough interest)

    Ride Options Pick 1! Wellington Abound

    Presidents Tour de Mystique

    Cheque included $ ................. or I have paid online ______/_______/ 2011 $......................


    Kiwibank : 38 9010 0403031 00 If paying online please use your surname and bike registration number
    as a reference. Postal address C/- 8 Frethey Grove, Naenae, Lower Hutt 5011.

    INDEMNITY:
    By signing this form and/or entering the rally site, I hereby agree to abide by the RULES and
    REGULATIONS covering this event and hold blameless any Officer, Member, or Associate of the
    promoters for any Injury or Accidental Damage which may occur whilst attending or travelling to or from
    the 2011 BRONZ Wellington Anniversary Rally.
    Signature: ..............................................................

    Date: ...............................................................

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