TRE/Trial Online Entry Form

= required

SEAC TRE

SEAC - Round 5

Date - 6 October 2018

Cams Permit Number - 518/0610/02

Competitor / Entrant

Name
Address including Suburb/Town and Postcode
Email Address
Phone Number
Payment Method	Online - Via EFT Cash - at office on Thursday nights (local entries only)
Cams Licence Number
Cams Licence Expiry Date

Driver

Name
Address including Suburb/Town and Postcode
Email Address if different to Entrant
Phone Number
SEAC Member Number
SEAC Driver Grade	A B (Novice)
Civil Licence Number
Cams Licence Number
Cams Licence Type
Cams Licence Expiry Date
Emergency Contact Name
Emergency Contact Phone Number
Supplementary Regulations	I have read and understand the Supplementary Regulations
Disclaimer Understanding	I have read, understood, acknowledge and agree to the risk warning, disclaimer and indemnity document including the exclusion of statutory guarantees, warning, assumption of risk, release and indemnity. (This document is on the website with the supplementary regulations)

Co-Driver / Navigator

Name
Address including Suburb/Town and Postcode
Email Address
Phone Number
SEAC Member Number
SEAC Driver Grade	A B (Novice)
Civil Licence Number
Cams Licence Number
Cams Licence Type
Cams Licence Expiry Date
Emergency Contact Name
Emergency Contact Number
Supplementary Regulations	I have read and understand the Supplementary Regulations
Disclaimer Understanding	I have read, understood, acknowledge and agree to the risk warning, disclaimer and indemnity document including the exclusion of statutory guarantees, warning, assumption of risk, release and indemnity. (This document is on the website with the supplementary regulations)

Vehicle Details

Make
Model
Colour
Year
Registration Number
Registration Expiry Date
CAMS Log Book Number
Engine Capacity
Turbo / Supercharged	Yes No
Drive Type	2WD 4WD
Correspondence to	Competitor Driver Co-Driver
	SUBMIT ENTRY