MG Car Club of South Australia
ENTRY FORM
2018 ANNUAL AUSTRALIAN KIMBER RUN - SUNDAY 11th November 2018 ENTRIES CLOSE FRIDAY THE 26th October 2018
This entry form is required to be completed and the “ Conditions of Entry ” ( page 29 ) must be signed as acknowledgement of such conditions and forwarded with appropriate fee together with a stamped self addressed envelope or your email address for your confirmation of entry Entry costs : A registration fee of $ 29.00 per vehicle applies . A further $ 20.00 per person is payable to cover the cost of a sit-down barbecue lunch at Bridgewater Motor Museum BYO chairs and drinks Entrants & Vehicle Details :
NAME :……………………………………………………… PHONE ........................ ADDRESS :……………………………………………………… POST CODE : .............. Email Address .......................................................... CAR : MG ………… MODEL :……………………….. YEAR ……………… REGO NO . ……………. . COLOUR :................................
NOTE : Entry is subject to the Conditions of Entry , overleaf , which must be signed by the owner / driver in acknowledgement of these conditions .
Payment Arrangements : Registration @ $ 29.00 Number of Meals …………@ $ 20.00 per person $...................... Total $............................
Special meal requirements ................................................................ No Required ....... Payment by ; ( Please circle ) CASH / CHEQUE or CREDIT CARD If paying by Credit Card ( Please circle ) ( 1 ) MASTER CARD or ( 2 ) VISA
Card No .
Card Holders Name …………………………………………………
Card expiry date . Card Holders Signature :……………………………………………………
Please make all Cheques & Money Orders Payable to : MG Car Club of SA
Return completed entry forms to : 2018 Annual Australian Kimber Run C / - MG Car Club of SA Inc PO Box 200 , Brompton SA , 5007
Together with a stamped self addressed envelope please !! Or your email address In legible writing ( do not use upper case writing if your address is in lower case )
Any further information please contact : Berry Treffers , AAKR Co Coordinator by Mobile 00434 485 331 or by email : berry . trefers @ gmail . com
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