MR2 QLD Navigation Challenge Entry Form

1

Drivers Name* This field is required.Please provide us the name of the driver

First Name

Last Name

2

ICC - Driver Nominated Club and Member Number eg MR2 QLD - 007* This field is required.This is for the points to be awarded for the purposes of the Inter Club Championship. If you aren't part of a Motosport affiliated car club please join a car club that is affiliated with Motorsport Australia - like the MR2 QLD Club!.

3

Navigators Name* This field is required.Please provide us the name of your navigator.

First Name

Last Name

4

Navigator - Nominated ICC Club and Member Number - eg MR2 QLD - 007* This field is required.This is for the points to be awarded for the purposes of the Inter Club Challenge. If you aren't part of a car club and would like to still enter please continue with entering MR2 QLD.

5

Registration Plate, Make and Model of the Vehicle you will be driving.* This field is required.If your registration has lapsed it needs to be renewed - it's that simple. If you are not sure which vehicle place NA into the field for now. We will be checking the vehicle on the day so please come prepared as we will perform a safety check on each vehicle to ensure your indicator lights are working.

6

Please provide your mobile phone number:* This field is required.Just so if we need to contact you for any reason on the day we can do so.

Phone

7

Emergency Contact Name & Number* This field is required.In the unlikely event of an emergency please provide your next of kin name and contact details.

Name / Phone Number

8

Please provide your E-mail for receiving further instructions* This field is required.

9

Stanley's Barn - Lunch Reservation* This field is required.Seating for lunch at Stanleys Barn - The Gold Coast Car Museum at the final destination. Will you be attending lunch and require seats to be reserved. Two seats will be reserved. A deposit will be paid on your behalf from the entry fee. There is a limited lumch time menu available - follow the link below MENU Chicken Burger Beef Burger Open Steak sandwich Risotto

YESNO

10

Driver and Navigator - Entry Fee For obvious reasons each vehicle entered will need two occupants, one being the driver and one being the navigator as a minimum. There is an entry fee of $25 per vehicle, entrants are welcome to have more than one other person in the car with them on the day, the more the merrier.

MR2 Navigation Challenge 2023
follow the links in the email we send you.
$25.00AUD for each day
SUBSCRIBE

11

Where to find updates and online info about the event - Like our Facebook PageSo you can see photos from the event on the day and any updates, please like our Facebook page below.

12

Your Entry Number

13

Once you submit this entry application, we will be in contact via email to provide our bank account details to pay for your entry, along with some extra details about the event on the day.

Thank you from all of us at the MR2 QLD team, we look forward to seeing everyone on the day!