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first name:
surname:
email:
address:
city:
home phone:
cell phone : (useful for
txt updates)
weight:
kg
race category:
club:
transponder no:
(or
"hire")
race entry fee: $85 + $10 Transponder
hire? Entries close Sunday 25th Sept at 10pm
NZBAI is organising
dinner on Saturday
night and invites competitors,
partners and supporters to join them.
This is booked at Mount Maunganui Golf Club:
book for dinner:
$35pp (pay with registration)
Lunches are available for pre-order at $5 each (4 days = $20)
Order Lunch: Thurs
Friday
Saturday
Sunday
Please pay by direct bank deposit into our
National Bank
a/c
number 06-0379-0109819-00
(ensure you include your name, otherwise, thank
you for your donation!), or by a cheque made out to New Zealand
Blokart Association and post to NZBAI C/o blokart®
International Ltd PO Box 11320 Papamoa 3151 (make sure chq
arrives by 22nd Sept to avoid paying twice!)
Make sure you read and understand the
Notice of
Race and
Rules
for this event.
Release and Indemnity
-
I/we agree to comply with the rules and
by-laws of New Zealand blokart Association Inc.
-
Should I cause any injury or damage to
myself/my associates, any other patrons, to any members of the
public or to any property, waiver any form of liability to the
Members of NZBAI. against all actions, claims or expenses in
respect of any such injury or damage.
-
NZBAI. have the absolute right to refuse any
person.
-
I am aware that I am entering this event at my
own risk.
-
I agree for NZBAI. to retain the information
on this form for marketing purposes.
I have read and understood the rules and disclaimer. I
intend to have an awesome time and will be a good sport!
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