Amazing Race Entry Form 2009

 

"use this form below to electronically submit, for other methods just print out this form"

 

     "Silverstones" Amazing Race (2nd-4th April 2010- Easter Weekend)

 

Team name :          

Team postal address:

Team email address:  (Will email instead of post)

Optional 2nd Email address: 

Telephone number with contact name:  

 

Driver

Navigator

Plese type in this box any additional passengers names and if under 18, their age as well please. This is so we can cater for the Sunday night BBQ and also for any children prizes, etc

 

Total cost is:

$320

 

No extra charge for more passengers

Fee includes all maps, notes and free BBQ; soft drink and alcohol provided for Sunday evening presentation

 

 

 

Total Amount (pay on the day or submit your credit card details)

$ 320.00

Credit Card Number *note 1.5% surcharge applies if paying by credit card
Expiry Date  
Account Name

Paoletti's Maps to 15 Nirvana Close, Langwarrin South Vic 3911.

Or fax your entry form on (03) 9776 6798 or Telephone 0428 534 102