February 9, 2018 offroad

Competition Entry Form

SHORT COURSE – 2 DAY CLUB EVENT

3rd & 4th October 2020

Entry Fee $75     Kiwi Trucks $30     

Payment Information

All payments are to be made to:

Canterbury Off-Road Club

03 1593 0018939 00  (NOTE CHANGE OF BANK ACCT NUMBER)

(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.