Queen's Birthday Blokart Bash

Organised by

Capricornia Blokart Club Inc.

Mulambin Beach, Yeppoon.

11th - 13th June 2016

______

A weekend of fun blokarting and socializing on the beautiful Capricorn Coast.

Team relay events.

Racing with shadows. (2 people per kart)

Racing with deuce bars. (Connecting karts together)

Social racing.

BBQs and social gatherings.

ENTRY FORM

Complete and send to:

Via Post: Via E-mail:

Capricornia Blokart Club

6 Bowls Street PH: 0481 058 088 or 0407 157 523

Yeppoon, Qld 4703

The Queen's Birthday Blokart Bash will be held 11th-13th June 2016on Mulambin Beach, Yeppoon. Queensland.

Schedule:

Friday 10th June 2016All DayPractise Day

5.00 - 6.00pmRegistration

Saturday 11th June 20168.00 - 8.30amRegistration

9.00amSocial Racing

Relays

Shadow Races

Deuce Bar races

5.30pmBBQ and Social

Sunday 12th June 20169.00amSocial Racing

5.30pmBBQ

Monday 13th June 20169.00amCruise from Bangalee

to Sandy point, Corio Bay and back.

(Weather permitting)

This is a fun social event and the above schedule is only a guide.

Entry Form:

First Name:______Surname:______

Gender:Male / FemaleAdult / Child

Postal Address:______

Land Phone:______

Mobile:______

E-mail:______

Club:______

Category:Production or Performance

DO you have a Shadow. Yes/No

DO you have a Deuce Bar. Yes/No

Entry Fee:

This is a free event for existing Capricornia Blokart Club Inc. members and members of other affiliated Blokart Clubs.

For non-club members (e.g. not a current member of Capricornia Blokart Club or affiliated clubs) a fee of $20 per person to cover insurance.

Registration is due two weeks prior to the event - Saturday 28th May 2016.

Catering:

As there is limited catering on location, the local members will prepare a sausage sizzle for lunch each day and will also provide a barbeque dinner on both Saturday and Sunday nights. A bar will be operating for our convenience

Pre-ordering your Saturday and Sunday night barbeque is required.

Soft drinks and bottled water will also be available.

The Capricorn Palms Tourist Park can do fish and chips on the Friday night, but we need to let them know of approximate numbers in advance so if you think you want fish and chips on the Friday night please indicate how many serves you may want in the box on the entry form and we will pass this on to them. You will still need to order on the day this is just so they can be prepared.

Safety:

For safety all participants shall wear helmets, seat belts, and closed-in shoes when blokarting.

Accommodation.

The Big 4 Capricorn Palms Holiday Village is offering a 10% discount if you mention you are from the blokarts when you book.

More Information:

For more information, contact Paul Effeney 0481 058 088 / 0407 157 523.

If you are interested in volunteering for course setting, scoring or sausage sizzle, we would love to hear from you! Please call!

ENTRY DETAILS
Classification / Cost Per person / Quantity / Sub-Total Cost
Blokart Club Member / Free / x
Non Club Member / $20.00 / x / $
Sub Total / $
CATERING
Saturday Night BBQ
Adult / $15.00 / x / $
Saturday Night BBQ
Child under 15 / $7.50 / x / $
Sunday Night BBQ
Adult / $15.00 / x / $
Sunday Night BBQ
Child under 15 / $7.50 / x / $
TOTAL COSTS / $

Notes:

Soft drinks will be available on the beach with the sausage sizzle on Saturday and Sunday.

Friday night Fish and chips please indicate number of serves required. ______

Catering Payment Details:

Cheque:

Please make payable to: Capricornia Blokart Club Inc.

Direct Credit:

Bank of QLD

Acc Name: Capricornia Blokart Club Inc.

BSB# - 124 001

A/C# - 22259504

Place name in reference section.

Release and Indemnity

Capricornia Blokart Club Inc. will take all reasonable steps to safeguard every competitor in the Queen's Birthday Blokart Bash.

In consideration of your permitting registration of this child/ren or yourself to participate in the above Blokart sailing activities, the participant/s do hereby release Capricornia Blokart Club Inc. and all affiliated and/or associated organisations, together with their representatives, members or agents, of and from any and all demands of any kind or nature whatsoever, arising out of or in any way related to any participation in activities such as and including personal injury or death which may be suffered or incurred as a result of participating in such activities, whether or not caused by the negligence or wrongful acts of such persons or any agents or members of the Capricornia Blokart Club Inc. The participant/s further agree to indemnify and hold harmless each of them of and from any and all claims, demands, or actions of any kind or nature whatsoever arising out of any injury or damages incurred by the registered participant.

Signed:Date:

Emailed entries are to be signed by the participant (or Legal Parent / Caregiver) at registration. Electronic lodgement constitutes agreement with conditions.

Accommodation available onsite can be booked through:

Capricorn Palms Holiday Village

Wildin Way

Mulambin Beach Qld. 4703

Ph. 1800 068 703

View Capricorn Palms at:

Please call Capricorn Palms direct (not via email) this is peak season for them so book early. Tell them you're with the blokart group for the discount.