Registration

Fill out the following form to register you details or download the PDF version of the form and send directly to the details on the Contact Us page. (*) Required

Name of Organisation *
Contact Name *
Address

Phone *
Email *
Team Name *
Team Leader
Category (select grade) *

If runners or carts are being used for another team please specify team’s name and category.

Team Name

Disclaimer

* As the official entrant to the Billy cart Grand Prix and I hereby state that I have read the rules and I am willing to comply with them including the procedure for any disputes. I understand that the entry fee of $30 is to be paid by 25th August 2009. Payment can be sent to:

Payable to: Billy Cart Grand Prix
PMB 1
Lilydale VIC 3140

Note: Entries Close Wednesday 25th August 2010