Form here - Carnarvon Speedway

2015 STREET STOCK PERPETUAL
NOMINATION FORM – 28th March, 2015
NAME
CLUB
ADDRESS
CAR #
EMAIL
MOBILE #
INSURANCE TYPE
INSURANCE #
CAR MAKE
CAR MODEL
DO YOU REQUIRE TO HIRE A TRANSPONDER – YES or NO (please circle)
IF NO – YOUR TRANSPONDER # ................. (To save time on race night, it’s important that we know your number in advance please)
SPONSORS
TRAVEL DOLLARS PAID – Maximum $250 paid out per driver
From South of Perth $250
Perth
$200
Geraldton
$150
Shark Bay
$ 80
Karratha
$150
Port Hedland $200
Broome
Nomination Fee : $ Nil (gate admission to be paid by non-members)
Transponder Hire Fee : $10.00 (to be paid by non-members)
$250
Late Nominations : Run rear of field
th
Nominations Close : 24 March, 2015
Send Nominations : via email [email protected] or fax 99 411 287
RULES and REGULATIONS
Carnarvon Speedway Club (Inc) runs under the ASCF Speedway Sedans Australia racing rules, regulations and code of conduct.
If there should be any unforeseen circumstances that cause stoppage of this event, the Carnarvon Speedway Club Executive
Committee shall make the final decision in regards to allocation of prizes, money and trophies.
Complimentary BBQ, trophy and travel money presentations will be held in the club house at the completion of racing – all welcome
Camping and hot showers available at the track
A minimum of 5 nominated race cars are required to host this event
Scrutineering commences 4.30pm
Drivers briefing 6.30pm
Racing commences 7.00pm
I HEREBY AGREE TO ABIDE BY THE CARNARVON SPEEDWAY CLUB (INC) RULES AND REGULATIONS AND ALL DECISIONS MADE BY THE
APPOINTED OFFICIALS AND COMMITTEE.
Signed__________________________________________________________________
(to be signed by both driver and parent/guardian if under the age of 18)
President
Vice Pres
Secretary
Secretary
Treasurer
Wade Mason 0409 276 933
Lance Root 0437 485 991
Leticia Moorfoot 0432 743 909
Tammy Chapman 0429 871 283
Paula Mogg 0408 913 166
Proudly sponsored by
CARNARVON GLASS and
WINDOW TINT
Dated______/______/______