Amazing Race Entry Form Name Easter 18th, 19th, 20th April, 2025 Easter 18th, 19th, 20th April, 2025 Your Name: * Your Email: * Your Contact Number: * Optional Second Email: Postal Address: (inc. postcode and state) Team Name: Driver's Name: Navigator's Name: Total cost is $360 Fee includes all maps and notes. Free Presentation BBQ. No extra charge for more passengers.. Payment Options: $100 deposit required on submission of your entry. * Visa or Mastercard Direct Debit Enter Amount * Payment Plan: select if wanting deduct my card $25 per month deduct my card $50 per month deduct my card $75 per month I will direct debit per month Credit Card Numbers: Name on Card: Expiry Date CCV Number Please type in this box any additional passenger's names and if 15 and under, their age as well please. This is so we can cater for Sunday Presentation and also for children prizes and course notes. Please also advise if any special dietary requirements. Post to: Navrun 4wd Events, 15 Nirvana Close, Langwarrin South Vic, 3911. Or Fax your entry form to (03) 9776 6798 or Telephone 0428 534 102. Or Direct Debit: Account Name: Navrun BSB: 033 362 Account Number: 113 505 *click here to view Conditions of Entry and Refunds I have read and acknowledge the Conditions of Entry and Refunds *
