February 9, 2018

Competition Entry Form

SOUTH ISLAND SHORT COURSE NATIONAL ROUND

10th APRIL  2021

Entry Fee $220     Kiwi Trucks $75     

Payment Information

All payments are to be made to:

Canterbury Off-Road Club

03 1593 0018939 00  

(Please indicate name and car number as a reference on internet banking payments)

Entry Details

    Driver Information









    Next of Kin

    Driver's next of kin.



    Owner Information

    To be completed if owner of vehicle is other than driver.





    Vehicle Details





    Prizegiving

    Payment Method

    I have read and accept the indemnity.