Onsite Rental Group Driftkhana Round 4
Online Entry Form
I acknowledge that I have read and understood the rules and regulations outlined in the Supplementary Regulations for this event
Competitor (Vehicle Owner)
*
First Name
Last Name
Driver
*
First Name
Last Name
Drivers Address
*
Street Address
Street Address Line 2
City
State
Post Code
Drivers Mobile Phone Number
*
Please enter a valid phone number.
Drivers E-mail
*
example@example.com
Come & Try
Drivers Motorsport Australia Licence
*
Number
*
-
Day
-
Month
Year
Expiry Date
Drivers Club Membership
*
Club Name
Number
*
-
Day
-
Month
Year
Expiry Date
Drivers Emergency Contact
*
First Name
Last Name
Mobile Number
Car Details
*
Make
Model
Year
Capacity
Registered
Registration (Third Party Extension required for the day)
*
Registrarion Number
Expiry date
Payment
Bank Transfer (REF: Drivers first initial & surname + Drift
Cash or EFTPOS on the Day
Pay Now via Square (see below)
Driver Signature
*
-
Day
-
Month
Year
You can pay your entry fees easily right now via Square as below : )
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Senior Entry
$
65.00
AUD
Junior Entry
$
50.00
AUD
Come and Try License
$
35.00
AUD
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Submit
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