Officials Registration Form

2025 Targa Tasmania - Officials Registration Form
EVENT REGISTRATION
EVENT
PREFERRED TEAM OR STAGE
YOUR DETAILS
FULL NAME

First NameSurname
CONTACT DETAILS

Street Address

Street Address Line 2

CityState

Postcode
PHONE NUMBER
Format: 0000000000.
E-MAIL
example@example.com
EMERGENCY CONTACT DETAILS

Full Name

Relationship

Contact Phone NumberState / Province

Postal / Zip Code
EXPERIENCE & QUALIFICATIONS
DO YOU HOLD AN OFFICIAL'S LICENCE?
IF YES, PLEASE PROVIDE DETAILS BELOW:

Issuing Motorsport Body

Licence Number

Licence NumberExpiry

PAST RALLY OFFICIAL EXPERIENCE (leave blank if you are a first time official)

Rows	Event Name	Dates	Role
1
2
3

PLEASE INDICATE YOUR AVAILABILITY FOR THE EVENT:
IF YOU ARE NOT AVAILABLE FOR THE ENTIRE EVENT, PLEASE SELECT YOUR AVAILABILITY:
GENERAL HEALTH
DO YOU HAVE ANY HEALTH PROBLEMS THAT TARGA AUSTRALIA SHOULD BE AWARE OF?
Should be Empty: