013 –MARCH 29TH – 1ST APRIL
ENTRANT DETAILS (ENTRANTS MUST BE FINANCIAL ASRF MEMBERS) ASRF NUMBER______(WILL BE CHECKED BY HEAD OFFICE)
SURNAME ______GIVEN NAME(S) ______
ADDRESS ______STATE _____ POST CODE ______
PHONE NUMBERS (H) ______(M)______CLUB ______
ENTRANTS VEHICLE (photo must be attached)
YEAR ______MAKE ______MODEL______REGO ______COLOUR ______ENGINE______
ASRF CLASS ______(Special Interest Class – pre 1976. limited event participation)
ENTRY FEESPLEASE MAKE CHEQUES PAYABLE TO ASRF 2013NATIONALS (credit card details can be phoned through to Head Office).
FAMILY $ 165 EARLY ENTRY (POST MARKED DEC 1ST 2012) AFTER 1/12/2012 FAMILY $200
SINGLE $ 110 EARLY ENTRY (POST MARKED DEC 1st 2012) AFTER 1/12/2012 SINGLE $135
BUDDY$60 EARLY ENTRY (POST MARKED DEC 1st 2012) AFTER 1/12/2012 BUDDY $70
NUMBER OF PEOPLE ATTENDING (YOUNG ADULTS [FAMILY ENTRY] 18 AND OVER BECOME BUDDY PASSES)
ADULTS ______BUDDIES ______CHILDREN ______CHILDRENS AGES ______
(BUDDY PASSES DO NOT INCLUDE GOODY BAG OR T-SHIRT) GOLD PASS MEMBERS MUST PRE ENTER
Please tick if you have attended all Numbered Nationals
One (1) FREE T-SHIRT XXXL XXL XL L M S
A MERCHANDISE FORM WILL BE RETURNED TO YOU WITH YOUR RECEIPT FOR ADDITIONAL T-SHIRTS, HATS, BELT BUCKLES, ETC.
ENTRIES AFTER 1stFEBRUARY 2013WILL NOT BE ELIGIBLE FOR FREE T-SHIRT OR GOODY BAG (NO EXCEPTIONS) SUB TOTAL $______
MEALSSATURDAY DINNER $18 PER HEAD (INCLUDING CHILDREN) ______NUMBERS ______
SUNDAY BREKKY $5 PER HEAD(INCLUDING CHILDREN) NUMBERS ______SUB TOTAL $______
MEALS NOT AVAILABLE FOR ENTRANTS ENTERING AFTER 1stFebruary 2013
CAMPING
AVAILABLE FROM WEDNESDAYMARCH 27th TO TUESDAY 2ND APRIL ONE PRICE $165 MAXIMUM 4 ADULTS PER SITE
TYPE OF VEHICLE I.E. MOTOR HOME, CARAVAN ETC. ______POWER SITE Yes No
Please indicate whether you can camp on bitumen as NO PEGS ARE ALLOWED ON BITUMEN Yes No
SUB TOTAL $ ______IF YOU WISH TO CAMP WITH YOUR MATES PLEASE CONTACT ROGER CAMPBELL 0407 126 269
TOTAL TOTAL$______
PLEASE READ AND SIGN DISCLAIMER BEFORE POSTING FORM
CONDITIONS OF ENTRY
REQUIREMENTS
1. CURRENT FULL OR YOUR STATE REGISTRATION SCHEME INCLUDING THIRD PARTY INSURANCE (PAPERS MAY BE ASKED FOR)
2. ROAD WORTHY AND TIDY APPEARANCE
3. NO OPEN HEADERS, NO METHANOL, NO STORING OF FUEL
GENERAL WARNING AND LIABILITY
ALL ENTRANTS, THEIR FAMILIES AND BUDDIES MUST CONDUCT THEMSELVES IN A CIVIL AND WELL BEHAVED FASHION.UNACCEPTABLE BEHAVIOUR WILL NOT BE TOLERATED, OFFENDERS AND THEIR PARTY WILL BE EJECTED FROM THE NATIONALS AND THEIR ENTRY CANCELLED WITH NO REFUND.
MOTOR SPORT IS DANGEROUS AND MAY RESULT IN INJURY OR DEATH TO THE PERSON OR PROPERTY. IT IS AN ESSENTIAL CONDITION OF ENTRY, THAT EACH ENTRANT OR SPECTATOR ACKNOWLEDGES THAT PRIOR TO ENTERING THE ASRF 2013 NATIONALS, PARKLANDS SHOWGROUNDS, AND/OR ANY DRIVING EVENTS, HE/SHE HAS MADE THEMSELVES AWARE OF THE DANGER AS A PARTICIPANT OR SPECTATOR AND/OR PROPERTY OWNER AND HAS ACCEPTED ALL RISKS.
THE ENTRANT, FOR HIMSELF/HERSELF, AND AS AN AGENT FOR ANY ACCOMPANYING CHILDREN AND BUDDIES, RELEASE AND DISCHARGE ABSOLUTELY THE PROMOTER, THE EVENT SPONSOR AND THE PARKLANDS SHOWGROUNDS’ AND THEIR EMPLOYEES, CONTRACTORS, REPRESENTATIVES, NATIONALS COMMITTEE, SUB COMMITTEES, AND AGENTS FROM ANY LIABILITY ARISING FROM ANY CIRCUMSTANCES WHATSOEVER.
ADVERTISING RELEASE
IT IS A CONDITION OF ENTRY THAT THE AUSTRALIAN STREET ROD FEDERATION(ASRF) HAS EXPRESS PERMISSION TO USE IMAGES OF CARS, PERSONS ETC. FOR PROMOTIONS AND ADVERTISING.
DECLARATION
I, THE UNDERSIGNED, DECLARE THAT I HAVE READ AND UNDERSTAND ALL THE CONDITIONS OF ENTRY AND AGREE TO ACCEPT ALL DIRECTIONS AND DECISIONS MADE BY THE NATIONALS COMMITTEE, SECURITYAND VOLUNTEERS DURING THE NATIONALS. I HAVE MADE MY PARTY, INCLUDING BUDDIES, FAMILY, AND CHILDREN, AWARE OF THE CONDITIONS OF ENTRY.
SIGNED ______DATE______
DO YOU HAVE ANY SPECIAL REQUIREMENTS TO MAKE YOUR NATIONALS MORE ENJOYABLE?
EG. BABIES NEEDS, WHEEL CHAIR ACCESS ETC.
WRITE THEM HERE AND WE WILL TRY OUR BEST TO ACCOMMODATE THEM:
POST TO:21st ASRF NATIONALS ENTRIES ENQUIRIES PHONE HEAD OFFICE(07) 55762100
POST OFFICE BOX 2569
BURLEIGH BCQLD 4220