Subaru Rally Tasmania

Choose the event you wish to enter

Kennedy's Welding Supples Southern Safari
1. Entry Details (Competitor/Entrant)
Is the Competitor/Entrant the Same as the Driver?*

YesNo
Competitor Name*
Mobile No*
Email Address*
Address*

Street Address

Street Address Line 2

CityState

Post Code
2. Entry Details (Driver)
Driver Name*
Civil Licence*

Licence NoExpiry Date
CAMS Licence*

Licence NoExpiry Date
Car Club

Club NameMember NoExpiry Date
Mobile*
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Post Code
Next of Kin*

NameMobileRelationship
3. Entry Details (Co Driver)
Co Driver Name*
Does the Co Driver have a Current Civil Drivers Licence*

YesNo
If the Co Driver does not have a valid or current Civil Drivers Licence, please download and complete this declaration and either attach to this entry electronically, or present at the time of documentation.
Civil Licence*

Licence NoExpiry Date
CAMS Licence*

Licence NoExpiry Date
Car Club*

Club NameMember NoExpiry Date
Mobile*
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Post Code
Next of Kin*

NameMobileRelationship
4. Entry Details (Additional)
Send All Correspondence to Email Address*
example@example.com
Sponsor Name
Team Manager

NameMobileEmail
5. Competition Vehicle Details
Vehicle*

MakeModelYear
Registration*

Registration NoExpiry Date
Colour*

Base ColourSign Writing Colour/s
6. Competition Category Details
TRC Class*
7. Service Crew
Service Crew Chief

NameMobileEmail
Will you be sharing with another competitor?

YesNo
Please specify
8. Service Vehicle Details (2 free with entry)
Service Vehicle #1
Service Vehicle #2
Add Another? (please note all additional vehicles will incur a charge)

Yes
Service Vehicle #3
Add Another?

Yes
Service Vehicle #4
9. Service Crew Details (8 free with entry)
Crew Member #1

NameMobile
Crew Member #2

NameMobile
Crew Member #3

NameMobile
Crew Member #4

NameMobile
Crew Member #5

NameMobile
Crew Member #6

NameMobile
Crew Member #7

NameMobile
Crew Member #8

NameMobile
Add More? (please note all additional crew will incur a charge)

Yes
Crew Member #9

NameMobile
Crew Member #10

NameMobile
Crew Member #11

NameMobile
Crew Member #12

NameMobile
10. Entry Fees
Payment via?*

EFTPayPal / Credit Card
Payment Via EFT;

BSB: 067-003

ACC: 28063934

Account Name: 500 Car Club of Tasmania

*please use Drivers surname as the reference
Payment Via PayPal / Credit Card
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Tasmanian Rally Championship Only$495.00AUD

Total $0.00AUD
The following must be presented at documentation, however you can upload now to save you time later;

Entry Disclaimer (will be emailed to you upon receipt of entry form)

Service Crew Disclaimer (will be emailed to you upon receipt of entry form)

CAMS Licences

Civil Licences

Club Licences

Vehicle Registration
UPLOAD your documents
Form Submission

Details of the person submitting the form
Submitted by*

First NameLast Name
Submitter Email*
example@example.com
Security Check*
Should be Empty:

1. Entry Details (Competitor/Entrant)

2. Entry Details (Driver)

3. Entry Details (Co Driver)

4. Entry Details (Additional)

5. Competition Vehicle Details

6. Competition Category Details

7. Service Crew

8. Service Vehicle Details (2 free with entry)

9. Service Crew Details (8 free with entry)

10. Entry Fees

Form Submission