Online Registration Form 2012 UniSA Australian HPV Super Series

When you use the submit button at the bottom of this form, you will be sent a confirmation code to the email address provided. 
You will require this confirmation code before you can finalise your registration. 

Team Details  
Entrant (Institution or Group) Name *  
Team (Vehicle) Name    
Team Manager Title    
Team Manager Surname *  
Team Manager First Name *  
Postal Address (street) *  
Postal Address (suburb) *  
State / Province * Other ( specify )  
Postcode / ZIP *  
Telephone (AH) *  
Telephone (Bus) *  
Telephone (Mobile) *  
e-mail *  

* = Required Field

 

Entry Fees
 

Date

 Venue Registration Fee  
26th - 27th May 2012 Victoria Park 6 hour $250.00 + gst  
28th - 29th July 2012 Victoria Park 6 hour $250.00 + gst  
13th - 16th Sept 2012 Sturt Reserve Murray Bridge $450.00 + gst  
     
 
 

Entrant Type
 
Please select the best description for your team:

  School - Government

  School - Non Government 

  University 

  TAFE 

  Non Institutional 

   

Age Category
 
Please select the age category of your team:

  Primary (Category 1.)

  Junior Secondary (Category 2.) 

  Senior Secondary (Category 3.) 

  Open (Category 4.) 

   

Other
 
Please include our team in the following category(s):

  All Female Team (Note : Must compete as All Female EVERY round) 

   
Expressions of Interest:

  We are interested in taking part in the Monarto Track Appraisal Day 

   

 

    
   
Invoice Total   AUD$ inc gst
     
I have read and understand the Conditions of Entry    
     
       
     

 

 

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