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Adelaide Rallysprint - Enter the Event

Adelaide Rallysprint – Enter the event

Please fill in your details below to enter the 2019’s Adelaide Rallysprint.

1. Entrant Details
Entrant Name*
2. Entry Details Driver
Driver Name*
First Last
Mobile*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Car Club Name
Next of Kin name*
First Last
Next of Kin Mobile*
Next of Kin Email*
Next of Kin Relationship*
3. Entry Details (Co Driver)
Co Driver Name*
First Last
Mobile*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Car Club Name
Next of Kin Name*
First Last
Next of Kin Mobile*
Next of Kin Email*
Next of Kin Relationship*
4. Entry Details (Additional)
All Event Correspondence To?*
- Driver
- Co Driver
- Entrant
- Other
*please note this will also be the postal address your Rally Box is sent to. Someone must be able to sign for the package
Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
5. Competition Vehicle Details
Make*
Model*
Year*
Registration No*
Category*
6. Service Crew Chief
Name*
First Last
Mobile*
Email*
7. Entry Fees
Entry For*
- Tour $ 750.00
- Spirit $ 1,150.00
- Challenge $ 1,250.00
- Competition/cat S $ 1,350.00
Entry fee
Additional (Non-Refundable) lunch tickets $ 20.00 AUD
Price: $ 20.00 Quantity:
Additional Road Book & Map Set $ 30.00 AUD
Price: $ 30.00 Quantity:
Extra Event Map/s $ 10.00 AUD
Price: $ 10.00 Quantity:
Extra Road Book/s $ 25.00 AUD
Price: $ 25.00 Quantity:
Total
$ 0.00
8. Payment Options
Payment via?*
- Credit Card (VISA or Mastercard Only) 2% surcharge
- EFT
Credit Card (VISA or Mastercard Only) 2% surcharge
Credit Card Surcharge $
Total $
To make payment via credit card please contact Ivar on 0418 834 311
EFT
Payment Via EFT:
BSB: 065 005
ACC: 10125410
Account Name: Rally SA
*please use Drivers surname as the reference and email payment advice to [email protected]
Mandatory Documents
All documents may be scanned and emailed to [email protected] – and if that is done, there will be no need to present these documents any further.

Crews are to present the following documentation via scan (preferred) or at Scrutiny
- – CAMS licences (Driver, Co-driver)
- – CAMS Club Membership Cards (Driver and Co-driver)
- – Vehicle Registration
- – CAMS Logbook
- – Civil Licence (for the Driver)
Motorsport is dangerous
CAMS and it's associated entities exclude all liability for your harm howsoever arising from your attendance at the event except to the extent prohibited by law.

Read full disclaimer »

By submitting this form, you accept these conditions and are deemed to have signed this waiver.
Name
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