Exhibitor Registration Form

1
What is your name?Please provide your name.
First Name
Last Name
2
Will anyone else be attending the rally with you?
YESNO
3
If you answered yes to the previous question, please provide the names of those attending the rally with you in the space provided below.
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4
AddressPlease provide your address so that we can send a registration confirmation pack to you.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Phone NumberPlease provide the best number to contact you on.
Area Code
Phone Number
6
EmailPlease provide your email address if you have one. This will allow us to forward regular rally updates.
example@example.com
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code? orReceiving the email may take a few minutes, thank you for your patience!
7
What club/organisation are you affiliated with?
8
Please provide your public liability insurance details below.This may include your membership card number if you are a member of ACRA (Qld) Inc., AHA or NHMA Affiliate Clubs. If you are not a member of one of these Clubs please provide the name of the insurer and policy number.
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9
Please upload a copy of the relevant Certificate of Placement/CurrencyIf you have a copy of the relevant Certificate of Placement/Currency please upload this now.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
Who is covered by the abovementioned insurance policy?Please provide the names of the people in your party that are covered by this policy in the space below.
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Ok
11
Name of Youth Exhibitor
First Name
Last Name
12
How old are you?
13
Tell us a little about yourself and the item that you intend to display at this year's event.
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Ok
14
Registration, Camping & Meals
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Registration FeeThis fee is payable by the exhibitor and all persons attending the rally with them.
$5.00+Edit
Back
Quantity
Subtotal: $0.00
Camp Site (Unpowered)This fee is per site per night.
$10.00+Edit
Back
Quantity
One Site
One Site
Two Sites
Three Sites
No. of Sites
Subtotal: $0.00
Camp Site (Powered) This fee is per site per night.
$15.00+Edit
Back
Quantity
One Site
One Site
Two Sites
Three Sites
No. of Sites
Subtotal: $0.00
Friday Night DinnerIf you wish to attend this Complimentary Dinner, please register to do so, this will assist us when making the catering arrangements.
$Free+Edit
Back
Quantity
Subtotal: $0.00
Saturday Breakfast (Adult)
$10.00+Edit
Back
Quantity
Subtotal: $0.00
Saturday Breakfast (Child)Child Under 14.
$5.00+Edit
Back
Quantity
Subtotal: $0.00
Saturday Night Dinner (Adult)
$30.00+Edit
Back
Quantity
Subtotal: $0.00
Saturday Night Dinner (Child)Child Under 14.
$15.00+Edit
Back
Quantity
Subtotal: $0.00
Sunday Breakfast (Adult)
$10.00+Edit
Back
Quantity
Subtotal: $0.00
Sunday Breakfast (Child)Child Under 14.
$5.00+Edit
Back
Quantity
Subtotal: $0.00
Total cost $0.00
15
When will you be arriving?
16
When will you be departing?
17
Will you require assistance unloading/loading your exhibits?
YESNO
18
Are you intending on displaying your exhibits as part of your Club's display?
YESNO
19
If you answered yes to the question above, what is the approximate area you will require to display your exhibits?This will help us calculate the total space required for your Club's display area.
20
What will you be exhibiting?Provide us an overview of what you will exhibiting at this year's rally. Information may include the make, model, year of manufacture and any other interesting information that you may feel is relevant.
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21
What events do you think you will participate in?
Grand Parade
Tractor Pull
Tractor Balancing
Slow Tractor Race
Novelty Events - Tractors
Novelty Events - Vehicles
22
I/We will abide by the safety guidelines as presented at the exhibitor's safety briefing and I/we agree and recognise that during the conduct of the rally I/we will be required to comply with directions from the Club's officers on site.
YESNO
Should be Empty: