AMERICARNA REGISTRATION FORM 25th – 28th February 2015 Registration Fees Fee Dates / Details Fee Fee Valid until 1st February 2015 $110.00 LATE FEE for all entries received in February $135.00 All passengers 15 years and over Children Under 15 years are Free $50.00 Vehicle and Driver Passenger Fee per person All registered entrants receive access to all closed road areas, entry to the Entrant Function & each car entry receives an Americarna 2015 Cap Please scan and email to toni@americarna.com or post this form to: Americarna NZ Ltd, PO Box 4234, New Plymouth - with a cheque made payable to Americarna NZ Ltd. Online payments can be made to TSB Bank, Account Number: 1539 53 069 3743 10 PLEASE COMPLETE ALL AREAS OF THIS FORM AS THE INFORMATION IS USED FOR EVENT PLANNING AND REPORTING Name Mr, Mrs, Miss, Ms Surname: First Name: (Please circle) Mailing Address: Address City: Post Code: Phone: Mobile: Contact Details Email: This is our preferred choice of communication. We may already have your email address but please still complete this section so we can ensure we have your correct information. Vehicle/Motor Cycle Details Passengers Make: Model: Year: Registration #: Total number of passengers (do not include driver): Please include names and ages of children (age required for those under 15years) Passenger 1 Name: Passenger 2 Name: Passenger 3 Name: Passenger 4 Name: Passenger 5 Name: TOTAL TO PAY Page 2 Is this your first Americarna Event?  Yes  No Please indicate which day/time you plan to register at our Registration Centre (opening hours listed below): Tues 24th  Wed 25th (Morning) Wed 25th (Afternoon) Thurs 26th  Fri 27th Please indicate which EVENT days you will be attending – this information assists us with our planning: Please note: The event plan is subject to change without notification.  Wednesday 25th Opunake  Thursday 26th Waitara / Inglewood  Friday 27th Stratford / Hawera / Friday Night Main Street Cruise  Saturday 28th AmeriCARnival – Downtown New Plymouth CBD  Saturday 28th Entrant & Sponsor Only After Party _______________________________________________________________________________________ Accommodation: What type of accommodation have you arranged? Please take the time to answer this question. This is valuable information which is used solely for reporting purposes.  Hotel  Motel  B&B  Campground  Own Home  Other – please state ________________________  With Friends/Family IMPORTANT: 1. To ensure Americarna runs smoothly it is important to know what events you will be attending - NOT JUST THE DAY YOU ARE ARRIVING. You MUST check in at Registration before participating in the event. This will ONLY be accepted at the main Registration Centre – New Plymouth Race Course. Hours: Date Tuesday 24th Wednesday 25th Thursday 26th Friday 27th Hours 12:00 noon – 9:00pm 8:00am – 8:00pm 8:00am – 3:00pm 8:00am – 9:30am - Last chance to register Note: Car washing facilities will be available at the Registration Centre 2. You agree to comply with the rules & regulations and event instructions of Americarna & TVET. The Management of Americarna NZ Ltd or TVET reserve the right to expel anyone driving or acting in an irresponsible or unsafe manner. 3. You acknowledge that there are risks involved in participating in an event involving motor vehicles/bikes and must participate in a manner that does not endanger either yourself or others. 4. You agree that any photos taken of your vehicle/bike by the media or our photographer can be used by Americarna NZ Ltd or TVET. 5. Open to vehicles/bikes of American Origin only and restricted to 600 cars. toni@americarna.com phone our office on 06-759 0027. If you are unsure, email 6. Cancellations will be accepted prior to 19th December 2014, however a $25.00 administration fee will be charged. Refunds will not be accepted after this date. 7. While all attempts and effects are made by Americarna NZ Ltd & TVET toward the safety of your property, no responsibility is accepted in any way by Americarna NZ Ltd or TVET for loss or damage to your property for the duration of the event. Please sign below to confirm that you agree to the above conditions and that all your details are correct. If you have any questions or need more information please email toni@americarna.com. Signature: Date: