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Star Torque 2015 Spring Edition Mercedes-Benz Club of NSW Inc
Star Torque 2015 Spring Edition
Mercedes-Benz Club of NSW Inc
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National Rally 2016 entry form<br />
Participants<br />
Surname:<br />
GivenName:<br />
PartnerSurname:<br />
GivenName:<br />
EmailAddress:<br />
PostalAddress:<br />
State: Post/Zipcode: Country:<br />
Homephonenumber:<br />
Mobile/Cellphonenumber:<br />
HomeMBClub:<br />
MembershipNo.:<br />
YourMBDetails(yourfavouriteifyouhave>one): Year: Model:<br />
RegistrationNumber: Type: Colour:<br />
Ifyouarebringinga4doorvehiclewouldyoubewillingtocarryextrapassengers?<br />
YesNoN/A<br />
Ifyouarenotbringingavehicle,doyourequiretransportduringyourstay?<br />
YesNoN/A<br />
Doyourequirewheelchairaccessoradisabilityfriendlyroom?<br />
YesNo<br />
Foodallergiesorspecialdietaryrequirements?(If'Yes',wewillcontactyou)<br />
YesNo<br />
ParticipationPackages<br />
Price(AUD): xQty: =Total:<br />
PackagesandDay3touroptions<br />
SingleandCouplespackagesincludeallexcursionactivitiesandoneRallyKit.<br />
Singlepersonpackagewithaccommodation $1,360.00 <br />
ChooseyourDay3activities/tours:<br />
Freetime/marketsAM:TheRocks(historic)PM:OperaHouse<br />
Couplespackagewithaccommodation $1,800.00 <br />
Indicate1or2peopleforeachDay3activity/touroption:<br />
Pleaseindicateyourbedchoice:<br />
Freetime/marketsAM:TheRocks(historic)PM:OperaHouse<br />
TwinDouble<br />
<br />
Guaranteeanoceanviewroom $120.00 <br />
<br />
Singlepersonpackage(noaccommodation) $680.00 <br />
ChooseyourDay3activities/tours:<br />
Freetime/marketsAM:TheRocks(historic)PM:OperaHouse<br />
<br />
Couplespackage(noaccommodation) $1,060.00 <br />
Indicate1or2peopleforeachDay3activity/touroption:<br />
Freetime/marketsAM:TheRocks(historic)PM:OperaHouse<br />
<br />
AdditionalRallyKit(includinggrillbadge)Eachpackageincludes1RallyKit $100.00 <br />
Excursions(alreadyincludedinpackages)<br />
<br />
ChoosefromtheseexcursionsONLYifyouhaveNOTselectedapackageabove<br />
Day1CocktailPartyNovotelwithdrinkspackage $100.00 <br />
Day2Kiamalunch $40.00 <br />
Day2ParkingatNovotel&citytransfers $80.00 <br />
Day3ParkingatNovotel&citytransfers<br />
$80.00 <br />
<br />
Day3ToursTheRocks(limited)andOperaHouse<br />
Day3Harbourcruise,dinner&drinkspackage(Paymentbefore30/9/15)<br />
$35.00<br />
$160.00<br />
Day4Bowrallunch $45.00 <br />
Totals:Earlybirddiscountsapplytopackagespaidinfullbefore1/9/15.FullPaymentmustbecompletedby1/12/15<br />
EarlybirddiscountforaSinglepersonpackage $50.00 <br />
EarlybirddiscountforaCouplespackage $75.00 <br />
<br />
FULLPAYMENTAMOUNT(totalofPackagesorExcursionslessDiscount): <br />
DEPOSITAMOUNT(onlyrequiredforPackages): $400.00 <br />
IhavereadtheCancellation&PaymentPolicy.SIGNED:…….………………………………………………….................<br />
PAYMENTS for Mercedes-Benz Clubs Naonal Rally 2016<br />
1. Cheques payable to: Mercedes-Benz Naonal Rally<br />
2. Direct Credit: BSB 012 217 Acc No: 2926 65345 Mercedes-Benz Naonal Rally<br />
Ref: Rally (and your name)<br />
3. Credit Card for the sum of: AUD_______________ VISA OR MASTERCARD<br />
Card Number: _______ _______ _______ ________ Name:_______________________________<br />
Card Expiry: _____/_____<br />
Cardholder signature:_______________________________<br />
4. Send completed form (plus any cheques in AUD) to: Mercedes-Benz Club 2016 Rally, c/o Simon Strauss,<br />
90 Boundary Rd, Wahroonga, NSW, 2076 OR please scan and email to: rally2016@mbcnsw,org.au<br />
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