Sponsor and Waitlist Entry Form

PLEASE READ THE BELOW INFORMATION CAREFULLY PRIOR TO COMPLETING THE FORM:

The appearance of this Entry Form may vary depending on the type of device you're using. For best results, please use either a Tablet or Computer, rather than a Mobile Phone to view and complete your entry.

Before completing this Entry Form, please read the Supplementary Regulations, Disclaimer Form AND Online Entry Form Instructions, located under "EVENT DOCUMENTS".

This Entry Form requires information regarding the Competitor/Entrant, the Driver(s) AND the Crew Member(s), so please have all of this handy before you start.

Once you have clicked the "Submit Entry" button, you will receive an automatic reply email with a notification that your Entry has been received, along with bank account details for Fee payment. The Entry Form and the Entry Fee must be received before your Entry is classed as complete. Also, along with the automatic reply, you will receive a copy of your entry submission.

IF YOU DO NOT RECEIVE AN AUTOMATIC REPLY, IT WILL BE FOR ONE OF TWO REASONS:
1. Your reply is hiding in your email Junk/Spam folder.
2. You did not complete all of the required fields (fields with a red star) and your entry was not submitted - go back and check the Online Entry Form Page for error messages.

Once we have received your Entry, it will be checked by organisers before it is accepted. An official acceptance email will be sent once finalised. Please be patient! This is a manual process and will take some time!

* EACH DRIVER MUST COMPLETE A SEPARATE ENTRY FORM!
* Only ONLINE Entries will be accepted.
* Only ONLINE Payment will be accepted.

= required

Email:

2022 LEGEND OF THE LAKES HILLCLIMB

Friday 11th, Saturday 12th and Sunday 13th November 2022

CAMS Permit # 522/1311/01

Please complete each field below IN FULL.
Please do not use "As Above" as a response, as doing so will result in incorrect data collection. If your entry includes "As Above" as a response, it WILL NOT BE ACCEPTED.

COMPETITOR/ENTRANT DETAILS

First Name
Surname
Address
Suburb/Town
State
Postcode
Competitor Mobile #
Email
Car Club	Please enter the name of your Car Club IN FULL (eg. "South Eastern Automobile Club", NOT "SEAC").
Car Club Member #
Car Club Expiry
MA Licence #
MA Licence Expiry

DRIVER DETAILS

Is the Driver the same as the Competitor/Entrant?	Yes No
First Name
Surname
Address
Suburb/Town
State
Postcode
Mobile #
Email
Car Club	Please enter the name of your Car Club IN FULL (eg. "South Eastern Automobile Club", NOT "SEAC").
Car Club Membership #
Car Club Expiry
MA Licence #
MA Licence Expiry
Emergency Contact Name
Emergency Contact Mobile #
Junior Competitor	Yes No
Is this your first time driving at Legend of the Lakes Hillclimb?	Yes No
Supplementary Regulations	I have read and understand the Supplementary Regulations.

DAYS ENTERING

Friday 11th November 2022	Yes No
Saturday 12th AND Sunday 13th November 2022	Yes No

VEHICLE DETAILS

Car Class - Friday
Car Class - Saturday and Sunday
Year of Manufacture
Make
Model
Registration #	If applicable.
Colour
Base CCs	Please enter a 4-digit number.
Turbo	Yes No
Supercharge	Yes No
Does the Vehicle have a Log Book?	Yes No
MA Log Book #

SHARED VEHICLE DETAILS

Multiple entries for any car are permitted (to a maximum of two per vehicle). The entries must be on separate Entry Forms.
Entries may only be entered in one Class and one Category and must not be transferred without the Clerk of Course’s permission.
Is this a Shared Vehicle?	Are you sharing this vehicle with another Driver? If so, the second driver MUST complete a SEPARATE Entry Form. Yes No

2nd Driver Details

First Name
Surname
MA Licence #

MEDIA & PROMOTIONAL DETAILS

Driver's Full Name
Driver's Age
Driver's Hometown
Driver's Occupation
Is the Driver a Rookie?	Yes No
How many years has the Driver been competing?
Prior National Competitions	Please list all National Competitions entered, including the year of Competition.
Prior State Competitions	Please list all State Competitions entered, including the year of Competition.
Sponsors
Additional Information	Any additional information to assist with promotion of the Driver.

PAYMENT DETAILS

Early Bird Entries close at 8.00pm on Tuesday 23rd August 2022
Entries close at 8.00pm on Monday 5th September 2022
Entry Fees	Please select your Entry Fee, as applicable.
Total Cost for Entry Fees	Please enter the total $ amount due for Entry Fees IN WHOLE NUMBER FORMAT (eg. "160", NOT "$160" or "$160.00". Use of $ sign and/or decimal points will result in error messages.
Do you wish to purchase additional Crew Passes?	Your Entry Fee includes Passes for 1 Driver and 2 Service Crew for each nominated day. 2 additional Crew Passes per Driver can be purchased for $10.00 each at the time of entry application. Due to COVID-19 Regulations, Crew Passes will NOT be available to purchase at the Event. Yes No
How many addional Crew Passes do you require? Can only be done when entering.	@ $10.00 each.
Total Cost for Crew Passes	Please enter the total $ amount due for additional Crew Passes IN WHOLE NUMBER FORMAT (eg. "10", NOT "$10" or "$10.00". Use of $ sign and/or decimal points will result in error messages.
Total $ Amount Due	Please enter the total $ amount due for Entry Fees + additional Crew Passes (if applicable). Please use WHOLE NUMBER FORMAT (eg. "170", NOT "$170" or "$170.00". Use of $ sign and/or decimal points will result in error messages.
Payment Method	Only EFT Payment will be accepted. Please email remittance to info@seacsa.com.

CREW DETAILS

Due to COVID-19 Regulations, Names of ALL Crew Members must be included at the time of entry application.
Number of Crew Members

1st Crew Member

First Name
Surname
Is there a 2nd Crew Member?	Yes No

2nd Crew Member

First Name
Surname
Is there a 3rd Crew Member?	Yes No

3rd Crew Member

First Name
Surname
Is there a 4th Crew Member?	Yes No

4th Crew Member

First Name
Surname