Corowa - March 9th to 12th ASRF sanction no. 17/14

Inc. no. A0005031A

ENTRY FORM

ITINERY

Friday 9th
Registration 6 – 8pm Tennis Club rooms at Bangerang Park
Dinner and drinks supplied / Sunday 11th
8.30 – 10am Breakfast at Tennis club
10am Ladies day bus leaves from Tennis club
11 – 2pm Show and Shine Bangerang Park
Approx. 3pm Ladies day bus returns
Saturday 10th
Registration 9 – 10.30am Tennis Club rooms
10.30 Cruise poker run social event finishing at
Bundalong Tavern for lunch / Sunday evening
6pm at the Corowa RSL Club
Dinner, live band and prizes for a relaxed social evening
Saturday evening
Crusin the main street (Sanger street) 6 - 9pm
“PLEASE SUPPORT THIS EVENT!” / Monday morning
8.30 – 10am Pancake breakfast and farewell to entrants returning home

Entry Fees Family: $120.00 (Couple & Children under 14) Single Adult $75.00

Couple: $100.00 (No kids) Young adult $30.00 (14-18yrs)

Ladies day bus fee: $45 (covers meal and bus. Dinks not included)

Entries Close 12th February 2018...... Late entrants not assured of T-shirt or goody bag.

Your Signature on this entry form releases the Wangaratta Rod & Custom Club Inc., from any claim of loss, damages or liability.

Signature:......

Name:……………………………………………Partner:………………………………No. of kids………

Postal Address:………………………………………………………………………………….……………

Town/Suburb:………………………………………………State……………………P/code:…………….

Phone/Mobile:………………………………..Email:……………………..………………………………...

Vehicle Make:………………………….Model:………………………..Year:………..Rego:……………..

Second Vehicle:………………………….Model:………………………Year:………..Rego:……………..

(Note: 2 car families may enter for judging however only one goody bag per entry)

One T-shirt included in entry fee.

T-SHIRT SIZE (please circle) XS SM MED LG XL XXL XXXL XXXXL

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Polo shirts can be ordered in place of entry t/shirt at an additional $15.00 (circle which is required)

POLO SHIRT (please circle) XS SM MED LG XL XXL XXXL XXXXL

Additional T-shirts $25.00 – Additional polo’s $40.00 (Please indicate numbers below)

Please forward your payment with this entry form and cheque made payable to: Wangaratta Rod & Custom Club Inc. P.O. Box 38 Wangaratta Vic 3676.

Alternatively direct deposit to WAW credit union BSB 803070 Account number 35694. Please put your entry name as your reference on payment and make a note on your entry as to bank transfer payment.

Phone Darren Proctor : 0412 098 351

Email: