Please Complete One Form for Each Vehicle

2014 REGISTRATION FORM

Please complete one form for each vehicle

SECTION 1: Contact Details

Driver #1 / Surname / Given Names
License No. / State of issue / ACTNSWNTQLDSATASVICWAOther
Driver #2 / Surname / Given Names
License No. / State of issue / ACTNSWNTQLDSATASVICWAOther
Passenger’ name/s / Age (if applicable)
Passenger’ name/s / Age (if applicable)
Passenger’ name/s / Age (if applicable)
Please provide ages of children
Address
Suburb/Town / State / ACTNSWNTQLDSATASVICWAOther / Postcode
Phone / Email address

SECTION 2: Your vehicle and 4WD experience information

Make / Model
Year / Colour
Registration Number / State / ACTNSWNTQLDSATASVICWAOther

Please check where appropriate:(Checked indicates YES)

The vehicle listed above has comprehensive insurance

The vehicle listed above has third party property damage cover

Driver #1has private health insurance

Driver #2 has private health insurance

Driver #1 has ambulance cover

Driver #2 has ambulance cover

Driver Experience

Pleasecheck the level ability that applies to you and describe your level of 4WD skills and experience. If in doubt please be conservative.(Checked indicates YES)Beginner Intermediate Advanced Instructor

SECTION 3: The Program

Below is the daily program information for the event (subject to change). The 2014 Event Program is on the Beyond Hotham website and should be referred to for more information on the trips and the track classifications. Some trips have maximum numbers, so you need to register early. We will contact you by email or phone if you need to change a preference.

Please check box for those activities you wish to participate in:

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Thursday March 13th

Registrations open 4pm – 9pm at the General Store, upstairs function area.

Chance to spend the afternoon settling into your accommodation

Self guided walking tour of Hotham Walking Tracks if you arrive early.

Dinner at The General Store 6.00-8.00pm (pay at the General on the night)

Friday March 14th Workshops for those new to 4WDing / Beginners and maybe a brush up for those advanced as well.

Meet at the Transit Lounge (downstairs in the Resort Management Board Office) at 8:00am for briefing for day trips, and for those doing workshops 8.15am

Workshops below are Strongly recommended for new or beginner 4WDers before you venture out with the Beyond Hotham Team.

Safe Chainsaw Practices Presented by FWDV 8.30am.

Fundamentals of your 4WD and how it worksBy Paul O'Rielly9am-11:30am.

Talking Tyres and Techniques with Adrian Smith 10.00am.

Winching and Safe Vehicle recovery– How To Do It Safely. Presented by FWDV 11:30am.

NAV_COMMS Workshop with Geoff Boulton 2pm-5pm. Highly Recommended (Sponsored by HEMA MAPS)

Day Trips start today for those who came to drive

Day Trip: Beyond Mayford & Kings Spur with Graeme Price.

Day Trip:The Blue Rag Track with Tony Wells.

Day Trip: The Dargo Trail with Graham Harris.

Day Trip: Buffalo Range with Andy Keily.

Day Trip: The Buckland and Wandi Loop withNoel Ham and the Wang 4x4 Club.

Happy Hour 6pm-7pm @ The General Store.

Local Historian & Author Ian Stapleton 8.00pm.

Official Opening & Dinner at the General Store from 7.00pm (pay at The General on the night).

Saturday March 15th

Day Trip: Dogs Grave and Beyond with Ross Gorell.

Day Trip: Stonewall/ Bulltown Spur with Graeme Price.

Day Trip: Billy Goat Bluff / Pinnacles with Graham Harris. (7.00am start on this trip its big day)

Day Trip: Down and Up Machinery Spur with Ross Grant. (Parks Vic)Special Beyond Hotham exclusive!

Day Trip: The Heli-Pads with Geoff Boulton.

Day Trip: Just over that Hill with Andy Keily

Day Trip: A Day at the Glen with Trevor Taylor. (Special Guest Presenter - Ian Stapleton)

Day Trip: The Buckland and The BuffaloRange with Noel Ham.

Sunday March 16th

Day Trip: Beyond Buckland with Gavin Moody and Andrew Swift.

Day Trip: Down and Up Machinery Spur! Mt Loch, Machinery Spur with Ross Grant (Parks Victoria.) Special Beyond Hotham exclusive!

Day Trip: Talbotville/Eaglevale Hut with Garry Doyle.

Day Trip: Trig Point and Historical Markers with Trevor Taylor and the Wang 4x4 club.

Day Trip: The Scenic Discovery Tour – One For The Photographers with Geoff Boulton.

Day Trip: The River To The Clouds with Graeme Price (7.00am Start).

Day Trip: On Any Given Sunday with Graham Harris

Day Trip: Harrietville and Wandiligong Divide with Noel Ham

Happy Hour 6pm-7pm.

7:30pm Dinner & Video, Slide Night at The General (pay on the night).

Monday March 17th

Preparation day for those participating in the overnight trips anddeparting Tuesday morning.

4 Day/3 night Overnight Trip: The Golden Footsteps Discovery Tour – Wonnangatta Trip with Gavin Moody, Andrew Swift and Steven Gribble. Camping out in swags, tents or slide-ons. Full fuel tanks required on departure. Recovery gear kit (compressor, tyre repair kit and tool box) essential. Self cateringOR

I / We would like tobe catered for the 3 evening meals while we are on The Golden Footsteps Trip.

Extra $50 per person – Please add to registration fee. (Please advise of any special dietary requirements)

4 Day/3 night Overnight TripThe Few Days Out - Howitt High Plains and Beyond with Graham Harris.Camping out in swags, tents or slide-ons. Full fuel tanks required on departure. Recovery gear kit (compressor, tyre repair kit and tool box) essential. (Self catering).

4 Day/3 night Overnight TripTheOther Side of Hotham - Mt Cobbler and the KingValley with Garry Doyle.Camping out in swags, tents or slide-ons. Full fuel tanks required on departure. Recovery gear kit (compressor, tyre repair kit and tool box) essential. (Self catering).

4 Day/3 night Overnight Trip(Out and About)SPECIALTRACKTRAILER OWNERS ONLY with Andy KeilyFull fuel tanks required on departure. Recovery gear kit (compressor, tyre repair kit and tool box) essential. (Self catering).

4 Day/3 night Trip: The High Country Huts Tour with Noel Ham

Tuesday March 18th

Note for some of the trips: camping out in swags, tents or slide-ons. Full fuel tanks required on departure. Recovery gear kit (compressor, tyre repair kit and tool box) essential. Self catering.

3 Day/2 night Trip:The Mt Battery Track Tour with Graeme Price.

3 Day/2 night Trip:Touring With Tricky Trev Glen Wills-Shannonvale-Omeo. OFF Road Campers ok(Mining relics everywhere on this trip and lots of things to see)

3 Day/2 night Trip:Take It Down A Gearinto Talbotville with FWDV Relaxing, Fishing, Short Day Trips with FWDV Off Road Campers ok.

3 Day/2 night Trip:Mt Emu / Bogong High Plains with Ross Gorell

Wednesday March 19th

Overnight trips continue…

Thursday March 20th

All overnight trips arrive back to Hotham late afternoon.

Settle back into your accommodation and unwind a bit.

Happy Hour 6-7pm.

Dinner at The General Store 6.00pm-8.00pm(Pay on the night) Have a couple of drinks and chat with the other participants and trip leaders and share a few stories of your own.

Friday March 21st

Day Trip: The Wrong Waywith Garry Doyle.

Day Trip: CynthiaRange with Graham Harris.

Day Trip: Women Behind the Wheel (Intermediate/advanced female drivers) with Irene Ham &Nicole Epema – Harrietville and surrounding 4x4 tracks.

Day Trip: The Big Loop with Andy Keily – Dargo High Plains, Sarah Spur, Selwyn Crk, Twins Trk.

Day Trip : The Wandi with Brian Vowles.

Day Trip: From The River to the Clouds with Graeme Price.

Day Trip: Just a Good Days Drive withTony Wells.

Saturday March 22nd

Day Trip: BlueRagRange & Mt Buckland with Senior Sergeant Doug Incoll, Victoria Police.

Day Trip: BuffaloValley and Surrounding Area with Noel Ham.

Day Trip: Stonewall / Bulltown Spur with Graeme Price.

Day Trip: CynthiaRange Extended with Graham Harris. Early start 7am

Day Trip: Wandiligong / Bright / Harrietville & Smoko with Andy Keily.

Day Trip: The Back Way with Gavin Moody. Early start 7am. Weather dependant on trip route.

Day Trip: Dogs Grave and the Upper Dargo with Ross Gorrel.

Official Awards & Presentation Night Gourmet Dinner 7pm at The General.

(Please advise of any special dietary requirements)

Sunday March 23rd

Farewell Sausage Sizzle Breakfast 8am – 10am. (Gold coin donation to local CFA)

Vehicle Check Up 10am – 12pm with Andy Keily at the Workshop.

SECTION 4: Conditions of Entry

Indemnity:

Conditions of Entry to the Mt Hotham Alpine ResortCrownLand (Reserves) Act 1978

Please read the following and sign at the bottom.

Entry and use of the Mt Hotham Alpine Resort Crown Land Reserve is permitted by the Mt Hotham Alpine Resort Management Board (MHARMB) subject to the following conditions:

1. MHARMB, its employees and agents shall have no liability whatsoever in negligence, breach of contract or statute or statutory duty to the driver/participant, their dependant/s or legal representative for personal injury (or death) suffered by the driver/participant in any way whatsoever.
2. The driver/participant acknowledges that 4 wheel driving and associated activities are dangerous with many inherent risks as a result of which personal injury (and sometimes death) can occur and the driver/ participant assumes and accepts all risk of personal injury (or death) arising from such activities.
3. Thedriver/participant shall comply with Four Wheel DriveVictoria’s Code of Ethics ( Parks Victoria’s Park Code ( and signs or other directions of the MHARMB and the right of entry and access to the Mt Hotham Alpine Resort Crown Land Reservesfailure to comply will/may be therefore suspended or cancelled.
4. The driver/participants appreciate that the program for Beyond Hotham 2014 may change at short notice and where possible an alternative activity will be offered.

Information for Participants

1.All participants must be registered and have completed and signed this form.

2.All participants need to complete and check boxes on the registration form to advise which trips they are doing and when.

3.All participants need to be respectful of the environment and drive only on designated roads and tracks.

4.All participants must appreciate that the program may change at very short notice and if instructed by emergency services follow their instructions.

5.Many of the trips planned as part of Beyond Hotham 2014 are within the Alpine National Park. All participants must comply with the regulations applying to National Parks. (

6.All participating vehicles need to be fitted with front and rear recovery points and carry a snatch strap and 2 rated shackles as a minimum.

7.It is the owners responsibility to ensure the participating vehicle is roadworthy and appropriately set up for each trip. All terrain tyres are preferred (70% tread minimum) and must carry a spare wheel with jack and wheel brace. 40/80Channel UHF radio is essential for all trips.

8.Please carry a first aid kit and if you have special needs it is your responsibility to be prepared. Eg epi-pens, asthma medication, Heart Medication etc.

DISCLAIMER:

The Mount Hotham Alpine Resort Management Board, Parks Victoria and Victoria Police accept no responsibility for any accident which might occur during Beyond Hotham 2014 and have not arranged any Personal Accident Insurance to cover participants who enter at their own risk. No Liability Insurance has been arranged to cover negligent acts by participants.

Driver # 1

I… have read and agree with the above Indemnity disclaimer.

Signature:…………………………………………………………. Date:……………………..……………

Driver # 2

I… have read and agree with the above Indemnity disclaimer.

Signature:…………………………………………………………. Date:……………………..……………

Participant / Extra Driver

I… have read and agree with the above Indemnity disclaimer.

Signature:…………………………………………………………. Date:……………………..……………

SECTION 5: Pricing

Pricing:

Beyond Hotham Standard Rate: $780 per vehicle (admits up to two people).

This rate includes the Official Opening Night Happy Hour for 2 people, Awards Night Gourmet Dinner Saturday 22nd for two, registration pack, all guided trips, workshops and activities during the ten day program. Accommodation, meals (aside from the Opening Night Happy Hour and awards night functions) and fuel are not included. Single person or additional persons are $295 inc GST each .

Fraternal Member$585 per vehicle (admitsup to two people).

A special discounted rate to reward our loyal Beyond Hotham attendees from years gone by! A Fraternal Member price applies to anyone who has attended three or more Beyond Hothams.

This rate includes the Official Opening Night Happy Hour for 2 people, Awards Night Gourmet Dinner Saturday 22nd for two, registration pack, all guided trips, workshops and activities during the ten day program. Accommodation, meals (aside from the Opening Night Happy Hour and awards night functions) and fuel are not included. Single person or additional persons are $295 inc GST each.

Weekend Warrior Attendee:(Fri, Sat, Sun) (inc Overnight Option)$400 per vehicle (admitsup to two people).

Can’t join us for the whole ten days, No problem you can participate in part of Beyond Hotham for the first weekend (March 14th–16th). Yourregistration includes an invitation to the official Opening Night Happy Hour and Social events throughout the weekend.

Overnight AdventurerAttendee:(Mon, Tues, Wed, Thurs )(4 Day/3 Night Trips)$450 per vehicle (admits up to two people).

Can’t join us for the whole ten days? No problem you can participate in part ofBeyond Hotham overnight trips 4 day / 3 night or a 3 day / 2 night trip of your choice.

Booking Selection (please tick):

Beyond Hotham Standard Rate$780(per vehicle inc GST, admits up to two people)

Beyond Hotham Additional Participants Rate – Each Participant $295 inc GST

Fraternal Member$585(per vehicle inc GST, admits up to two people)

Beyond Hotham Additional Participants Rate – Each Participant $295 inc GST

Weekend Warrior Attendee (3 x Day Trips) $400(per vehicle inc GST, admits up to two people)

Part Program Attendee (1x Overnight trip) $450(per vehicle inc GST, admits up to two people)

Single Day Adventurer ONLY(1x Day Trip) $100(per vehicle inc GST, admits up to two people)

SECTION 6: Payment

Payment Details:

1. Payment by Credit Card. We accept Visa orMastercard only

Card No: Expiry Date: /

Name on the Card:

I authorise MHRMB to debit the amount of $ from my credit card

Signature:…………………………………………………………. Date:……………………..……………

Contact Phone Number (BH):……………………………………………………………………………….

OR I have enclosed a cheque/money order made payable to Mt Hotham Resort Management Board

to the amount of $

Signature:……………………………………..…………………...Date:……………………..……………

Cheque payments are to be posted to PO BOX 188 Bright, VIC, 3741

Please return your form by one of the following methods:

1. Fax: 03 5759 3693
2. Email:Please scan your form as a low resolution document (no larger than 5MB) and email to

3: Post: PO Box 188, BRIGHT, VICTORIA 3741

Phone enquiries: 03 5759 3550

Complete your registration form into us by January 31st 2014to be in the draw to win a set of Mickey Thompson Tyres (to the value of $1200), kindly donated by Smiths Tyre and Battery, Bright!

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