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Written by David Tooth
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Friday, 27 June 2008 18:14 |
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LIGHTNING RIDGE POLICE BUSH SAFARI – 2008. . | Po Box 450 | Ph: (02) 6829 9799 | | Lightning Ridge 2834 | Fax (02) 6829 9711 | | | Manuel -
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.REGISTRATION FORM | | PLEASE NOTE THAT THERE MUST BE ONE REGISTRATION FORM PER VEHICLE | | | | SURNAME OF MAIN DRIVER: ___________FIRST NAME:___________ | | | | ADDRESS__________________________________________________ | | | | TOWN / SUBURB: ___________________________________________ | | | | POSTCODE:________________________________________________ | | | | HME PHONE: _______________________WK PHONE:______________ | | FAX: ______________________________________________________ | | | | EMAIL: ____________________________ MOBILE: ________________ | | | | MAKE, MODEL AND YEAR OF VEHICLE: _________________________ | | | | REGISTRATION NUMBER OF VEHICLE: _________________________ | | | | IS THE VEHICLE FOUR WHEEL DRIVE: YES / NO PETROL OR DIESEL | | | | WILL YOU BE TOWING A TRAILER / CAMPER: YES / NO | | | | DO YOU HAVE A UHF RADIO: YES / NO |
.. PASSENGER NAMES:. | | SURNAME | FIRST NAME | AGE IF CHILD | | | | | | | | | | | | | | | | | | | | | | | | | |
.. PLEASE USE THE MEAL ORDER FORM LINK TO ORDER YOUR EN ROUTE MEALS. ...To order your Bush Safari Shirts, please indicate number required IN THE BOX UNDER relevant size. Your shirts will be ready for collection on registration day. The cost of the collared shirts is $45.00 (all sizes the same cost).. . Please find attached a cheque or money order payable to “Lightning Ridge Bush Safari” for the amount of $500.00 being registration for one vehicle. I do understand that if I cancel this application within 2 weeks of departure, there will be no refund. I / we do not hold the organizers of the Lightning Ridge Police Bush Safari responsible or liable for any damage to persons or property which may be incurred on this trip.. . SIGNED: DATE:. | Enclosed is payment for: | | Safari Registration: | $............. | I am also ordering ___shirts at $45.00 each (non refundable):: Size/s: 1. 2. 3. 4. 5. 6. | $............. | | Meals as per order overleaf: | $............. | | Cheques payable to Lightning Ridge Police Bush Safari | $............. | TOTAL - |
$............. |
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Last Updated ( Friday, 04 July 2008 18:36 )
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