November 2019
ENTRY FORM
2019 ANNUAL AUSTRALIAN KIMBER RUN—SUNDAY 10 NOVEMBER 2019
This entry form is required to be completed and the “Conditions of Entry” (overleaf) must be
signed as acknowledgement of such conditions and forwarded with appropriate fee
together with a stamped self addressed envelope.
Entry costs. A registration fee of $30.00 per vehicle applies. A further $40.00 per person is
payable to cover the cost of a sit-down lunch at Serafino Winery.
Entrants & Vehicle Entry Details:
NAME.......................................................................................TELEPHONE..........................
ADDRESS.................................................................................................
..........................................................................................................POST CODE.................
CAR MG...............................MODEL..............................YEAR.......................................
REGO NO...........................................CO;OUR.....................................
NOTE: Entry is subject to the Conditions of Entry, which must be signed by the owner/driver
in acknowledgement of these conditions
Payment Arrangements:
Registration.....................................................................................................$30.00
Number of Meals.......................@ $40.00 each.............................................$
Payment by, CASH / CHEQUE / CREDIT CARD or EFT ....................Total $................
(1)
MASTER CARD or (2) VISA
Card Number
Card Holders Name.........................................................Card Expiry Date..............
Card Holders Signature..........................................................................
Note: If paying by EFT use BSB 105-078 Account No: 048486240 and ensure
the reference field says AAKR and your name.
Please make all Cheques Payable to: MG Car Club of SA and return completed
ALL entry forms to ..2019 Annual Kimber Run—together with a stamped self
addressed envelope.
C/- MG Car Club of SA Inc PO Box 200 Brompton SA 5007
Any further information please contact Berry Treffers, AAKR Co-Ordinator
by phone on Mobile 0434 485 331 Or by email: [email protected]
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