AASA Targa NZ Entry Form
The more you can put here, the smoother your documentation will be on the day. Thank You
Are you new to Targa?
*
Please Select
No
Yes
Yes, and would like to discuss further (Phone me)
Targa Entry Type?
*
Please Select
Targa Competition
Retro Targa
Targa Time Trial
Targa Tour
2 Day Regional Targa Competition
2 Day Regional Retro Targa
2 Day Regional Targa Time Trial
2 Day Regional Targa Tour
Driver Name:
*
First Name
Last Name
Drivers Gender
*
Please Select
Male
Female
Required for Event Insurance (It just is)
Drivers Address
*
Street Address
Street Address Line 2
City
Post Code
Country
Drivers Phone Number:
*
-
02XX or Area
Phone Number
Drivers Email Address:
*
example@example.co.nz
Drivers Emergency Contact can't be in the same car
*
First Name
Last Name
Drivers Emergency Contact Relationship
*
Wife, Husband, Mother, Father, etc
Drivers Emergency Contact Phone Number:
*
-
02XX or Area
Phone Number
Drivers Civilian Licence:
*
Licence Number
Expiry Date
Photo of Civilian Licence
Browse Files
Drag and drop files here
Choose a file
Or email it to info@targa.co.nz
Cancel
of
Drivers AASA Competition Licence:
*
AASA Licence Number
Expiry Date
Photo of AASA Competition Licence
Browse Files
Drag and drop files here
Choose a file
Or email it to info@targa.co.nz
Cancel
of
Co-Driver Name:
*
First Name
Last Name
Co-Driver Gender
*
Please Select
Male
Female
Required for Event Insurance (It just is)
Co-Drivers Address
*
Street Address
Street Address Line 2
City
Post Code
Country
Co-Drivers Phone Number:
*
-
02XX or Area
Phone Number
Co-Drivers Email Address:
*
example@example.co.nz
Co-Drivers Emergency Contact can't be in the same car
*
First Name
Last Name
Co-Drivers Emergency Contact Relationship
*
Wife, Husband, Mother, Father, etc
Emergency Contact Phone Number:
*
-
02XX or Area
Phone Number
Co-Drivers Civilian Licence:
*
Licence Number
Expiry Date
Photo of Civilian Licence
Browse Files
Drag and drop files here
Choose a file
Or email it to info@targa.co.nz
Cancel
of
Co-Drivers AASA Competition Licence:
*
AASA Licence Number
Expiry Date
Photo of AASA Competition Licence
Browse Files
Drag and drop files here
Choose a file
Or email it to info@targa.co.nz
Cancel
of
Service Crew Manager:
First Name
Last Name
Service Manager Phone Number:
-
02XX or Area
Phone Number
Service Manager Email Address:
example@example.co.nz
Service Vehicle Details:
Rego Plate
Make
Model
Targa Vehicle Questions
Car Details:
*
Rego Plate
Make
Model
Year
Current Targa Car Number - if you already have one:
*
eg> 850
Engine Capacity in cc's:
*
Engine capacity, without correction factors (Turbo etc)
Engine Type:
*
Please Select
Rotary
Piston
Electric
Engine Aspiration:
*
Please Select
Naturally Aspirated
Turbocharged
Supercharged
Is your vehicle heavily modified?:
*
Please Select
No -within the technical regulations for production Class
Yes -Modified above production class regulations (Allcomers Class)
eg. Gearbox standard for vehicle? Wheel size not greater than 2" larger?
Photo of Vehicle for the Event Programme / Magazine
Browse Files
Drag and drop files here
Choose a file
A good advertising shot would be great
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Insurance
A minimum of Third Party insurance is required for all vehicles within Targa New Zealand
Copy of Vehicle Insurance
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Drag and drop files here
Choose a file
Or this can be provided at Documentation -or emailed through at a later date.
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of
Additional Comments or Questions you may have?
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