Registration Form

1st Participant (required)

Partner

Address

Phone/Mobile (required)

Email (required)

T-Shirt – First Participant

T-Shirt – Second Participant

I will pay by : (required)
Cheque Direct Debit PayPal

CHEQUE :
Made payable to:
Ride the Summit

Send to:
PC Guy JP
1555 Highway 2
RD 2
KATIKATI

DIRECT DEBIT :
Account:
Ride the Summit
38 9008 0077281 00

Ref: please put your name (no more than 8 letters) in this space.

Then email remittance of the reference name used, the registration names and the amount paid to ridethesummit@xtra.co.nz so we can easily match up who has paid and send you a
confirmation / nformation pack.

PAYPAL / CREDIT CARD:

After completing your registration form, please click the PayPal button at the bottom of the page, to be redirected to the PayPal payment process.

You do not required a PayPal account to use this facility – simply click on the ‘continue’ link, on the left hand side of the page you are redirected to.

Please ensure you complete the registration form first – so we can be sure of having all your details in our database!!

Enter security code in the space below :

Cost $112 per person

Meals

Friday & Saturday dinner are included in registration.
Breakfast at individuals cost.

Rally Packs

Rally registration pack on site will include: Rally patch, T-shirt, information and product. (late registrations may not receive a t-shirt)

Late registrations

Late registration may be accepted from 4th September 2010, but may not receive a FULL rally pack.
Numbers are limited, so late registrations will only be opened up if space is available.
Some rally patches and t-shirts may be available, but on a first come first served basis.