Chrysler Wake Run Entry Form

Entry is $20 per car, by Pre-Entry ONLY.
Please complete this form and then deposit money to:
Hunter Valley Chrysler Club
BSB: 637 000
A/c No: 712 917 660

Please use your name as the transfer note.

Name(*)
Please let us know your name.

Email(*)
Please let us know your email address.

Street
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Suburb
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State
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Postcode
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Phone
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Mobile Phone
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Days attending

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1st Car Details
Make
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Model
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Body Type
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Year
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Rego
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Colour
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Club
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2nd Car Details
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Model
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Body Type
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Year
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Rego
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Colour
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Please add any additional cars in the comment box below.
Chrysler Wake Run 2021 T-Shirts are available for $25 each.
Sizes: S M L XL XXL XXXL XXXXL XXXXXL
Let us know in the Comments which shirt(s) you'd like.
Comments
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Conditions of Entry

Entrants, by ticking the box below, agree that upon acceptance of their entry they shall release the Wake Run Committee and all persons connected with the organisation of the event from any and all liabilities for damage to any person or property.
Entrants further agree to accept all directions and decisions made by any member of the Hunter Valley Chrysler Club during the course of the weekend.
Agree to conditions of entry.(*)
Please tick the box to agree with our conditions.

Security Check(*)
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