Author: Sharon Hicks

28th Nov 2019 - 2nd Dec 2019

REGISTRATION FORM
Team Leader:
Name:
Phone Number:
Email Address:
DOB:
License Number:
Team Member 2:
Name:
Phone Number:
Email Address:
DOB:
License Number:
Team Member 3:
Name:
Phone Number:
Email Address:
DOB:
License Number:
Team Theme (if known):

On behalf of the above people, who are part of my team in the Hay Rust n Dust Outback Rally 2019, I agree to abide by the rules set out by the Hay Rust n Dust Outback Rally committee. I will deposit $400 per person as a registration fee and agree to raise $1,500 (by the 2nd Nov 2019) towards the rally total. If we fail to do either of these tasks or break the rules as set out, we understand that our position in the
Rally will be forfeited and all money raised will stay as part of the overall raised funds, non refunded.
____________________________________ _____________________________________________
PRINT NAME SIGNATURE & DATE