Silverfern Rally Registration – Targa New Zealand

Step 1 of 7

Driver 1
Last Name*
First Name*
Street*
Town*
Region*
Country*
Email address*
Phone
Is entrant identity different from driver identity?
- Yes
Entrant Details
(to be completed if Entrant identity is different to Driver identity)
Last Name*
First Name*
Email address*
Phone
Street*
Town*
Region*
Country*

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Driver 2 (co driver)
Last Name*
First Name*
Email address*
Phone
Street*
Town*
Region*
Country*

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Team manager Details
Last Name*
First Name*
Email address*
Telephone

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Address for Communications
(Identify person responsible for receiving Event Communications)
Contact Name*
Postal Address for event Communications*
Email Address*
Fax

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Vehicle Details
Vehicle Make*
Vehicle Model*
Year of Manufacture*
Engine Capacity (cc's)*
Event and Class

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Terms and Conditions
I have read and understand the Terms and Conditions*
- I understand
I have read and understand the Terms and Conditions

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Payment
Silverfern 2016 Entry
Price:
Total
$ 0.00
I have made payment*
- I have made payment to the following account;
Bank Name
02-0404-0255632-00
$11,000.00 including GST
I would like more information on...
- Shipping and car transportation
- New Zealand customs requirements
- Vehicle rental services
- Accommodation

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