2013 LOSKOP
HOP SA SA Pre-ENTRY FORM
|
RIDER DETAILS
NAME
& SURNAME
|
|
CONTACT
DETAILS
|
|
EMAIL
ADRESS
|
|
NAME
OF CLUB
|
|
AREA
OF RESIDENCE
|
INDEMNITY I ,
_________________________________ acknowledge that RIVERSIDE LODGE is a RIGHT
OF ADMISSION RESERVED PREMISES and I agree to adhere to the rules of the
organisers , as well as the owner of the property. I further agree to
participate in the 2013 LOSKOP HOP SA SA
Rally entirely at own risk and do hereby indemnify the organisers and
the owners of the venue and their agents
any claim what so ever, which may arise from my participation in the
said event. Firearms are strictly prohibited
Signature: ___________________________
|
NOTE: The pre entry R160 and proof of payment must
reach us before 28 June 2013
All
enquiries:
Jakes 083 769 7480, Jinx
073 405 7402, Kabouter 082 684 4580, Bom 072 513 8050,
Wurm 072 585 8444, Boela 082 827 4698
Accomodation
: Sterretjie 083 293 0379, Sunee
083 659 3578
Pre
entries :
Sterretjie 083 293 0379
Stalls
: Sunee 0836593578, Drinknux 082 837 3419,
Geitjie 083 444 2036, Bokkie 079 521 5817
Bank
details :Loskop Rally, Capitec Bank, Acc: 1249826959, Branch:
470010
No comments:
Post a Comment