P O Box 994, Emerald Qld 4720
Email: emeraldcarclub@gmail.com
Outback Classics Show & Shine Entrant Nomination
Personal details
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Car Club:
Vehicle Details
Make:
Model:
Year:
Entry:
Please choose one of the below. (Each full paid entry will recieve a Goody Bag on the day of the show.)
Note: $10 extra for each additional entry up to 3. $5 extra for each additional bike
$40 Car: Hot Rod
$40 Car: Classic (original)
$40 Car: Custom (modified)
$40 Car: Vintage
$40 Car: Project
$40 Car: Modern
$40 Car: Ladies
$40 Bike
$40 Ute
$40 4 x 4
$40 Truck
CONDITION OF ENTRY: All entrants are to observe the directions of officials on site. The organisers reserve the right to accept or reject entry.
Strictly NO entrant vehicles will be allowed access to the grounds after 9am once the entrants have been parked in allocated space.
The vehicle will not be moved by entrant or any other person before 5pm unless instructed by an official.
Expulsion from grounds may occur if: Directions are not followed, Any behaviour is found unfit by officials, There is any mistreatment of grounds ,There is any mistreatment of other entrants vehicles or personal belongings.
Entrants and vehicles may be filmed or photographed during this event and agree for images to be used for promotional purposes by the Emerald Car Club.
I agree to the conditions of entry as stated above, I agree that on acceptance of my entry I shall release the Council, the Emerald Car Club Inc, and all persons connected with the organisation of the show from all liabilities for damage that may occur to my property or person.
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Signature
All enquires can be directed to Greg on 0478 623 103 or Dave 0408 771 848.
Payment can be made into the following Bank Account – Suncorp Bank BSB – 484799 ACCOUNT NUMBER – 606310400 using your full name as the reference. Payments can also be paid on the day of the show at the Nomination Tent.
Submit
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