Easter Rally 2020 Registration Form

RHMC Easter 2020 Rally - Entry Form -

Please Note - Entries received after 3 April 2020 will attract a $10 late entry fee.
Person 1 Name*

PrefixFirst NameLast Name
Person 2 Name

PrefixFirst NameLast Name
Person 3 Name

First NameLast NameAge if under 18
Person 4 Name

First NameLast NameAge if under 18
Person 5 Name

First NameLast NameAge if under 18
Person 6 Name

First NameLast NameAge if under 18
Postal Address*

Street Address

Street Address Line 2

Town / SuburbState

Post Code
Email Address*
Future rally forms will be sent to this address
Email Preference

I would like to receive future rally forms via email
Best Contact Phone Number*
Vehicle Details*
Please provide Make / Model / Year
Full Name of Club
Special Dietary Requirements
Price per person below includes the Friday night BBQ, morning and afternoon teas on Saturday and Sunday, Sunday lunch and Sunday dinner (buffet).

Kid's menu meal includes a choice of nuggets & chips, fish & chips or crumbed sausages and chips.
Adults (12 years & over) - $75 each*
Children (4-11 years) requiring a full buffet meal at Sunday Dinner - $40 each
Children (4-11 years) requiring a kid's menu meal at Sunday Dinner - $25 each
Children (3 years and under - free)
IMPORTANT - We will only be catering for those entered in the rally. If additional people will be attending any of the rally activities with you, please contact the rally organisers for costings to be added to your entry.
Additional cost of of extra meals as discussed with rally organisers
Subtotal - Meals
Plus Nomination Fee (per vehicle) - $30
Grand Total Amount
Bank Details

Account Name: Roma Historical Motor Club Inc.
BSB: 034-211
Account Number: 790394

Please use your name and "Rally" as a reference
Transfer Complete*

I have deposited the grand total amount into the above specified bank account.
IDEMNITY*

The vehicle which I shall bring to the event is legally registered for such an event. I agree that the Roma Historical Motor Club Inc and associated organisations in this event will in no way be responsible for any loss or damage to the vehicle, parts or accessories or personal effects. The entrant and passengers hereby waive the right of action at law against the Committee.
Please verify that you are human*
Should be Empty:

RHMC Easter 2020 Rally - Entry Form -