V2 Motorcycle Run (2018):

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Caroline Hutchinson
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1 V2 Motorcycle Run (2018): Car Entry Form 18 to 21 October Primary Contact: Car # Crew Member #2: 1

2 Crew Member #3: (Additional $1,500 fundraising required) Crew Member #4: (Additional $1,500 fundraising required) 2

3 Car Details Make: Model: Year: Registration No: Fuel Type: Tank Capacity: Range: Tyre Size: Event Costs / Minimum Donation Car Entrant: Entry Fee $550 + Minimum Donation (based on 2 crew) $4,500 + Event Participation cost - per person $875 A further $1,500 minimun donation is required for each additional crew member TOTAL (based on 2 crew members) $5,050 + Event Participation cost - per person $875 Team entry: $550 Entry Fee - Inclusive of GST - non-refundable (payable on registration). Return with this form. *Please note: Until the Entry Fee is paid your V2 entry is not guaranteed + Minimum Donation - Raised via sponsorship or fundraising *This money is used to directly benefit the work of Variety SA. Other costs: 1. $875 Event Participation cost per person - this cost covers meals, accomodation, merchandise & entertainment on the event. *based on twin share accomodation 2. Vehicle purchase, preparation, maintenance 3. Fuel All other costs are not tax deductible 3

4 V2 Motorcycle Run Car Entry - Payment Details 18 to 21 October, (2018) 1. Cheque / Money Order / Cash returned with this form 2. EFT: BSB Account No: Ref: V2 2018/car# Amount: ($) Card Number: 3. Credit Card Online: Go to our website Click on the Donate button Expiry Date: Name on card: Type V / CAR # into the comments field Fill out your personal details Click Submit. You will be taken to the secure payment page, where you can enter your Visa, MasterCard or Amex details. 4. Credit Card (by Fax or Post only to ensure security of your details) 5. If the entry form is returned without the entry fee the Variety Office will send an invoice for this payment. Card type: Visa AMEX Mastercard By signing this entry form I agree to abide by the conditions of entry and code of conduct as attached. I agree to observe these conditions and all the subsequent amendments and additions. Failure to observe these conditions of entry may lead to cancellation of entry. There will be a limited number of entries on the V2 Motorcycle Run. You will be advised if your application has been successful. Variety may in its absolute discretion cancel the application of any entrants at any time prior to or during the event. Signature: Print name: Date: Please return this form together with your entry fee of $550 to Variety - the Children s Charity of South Australia a: 68 Richmond Road, Keswick SA 5035 t: f: w: varietysa.org.au e: ally@varietysa.org.au Office use only: Amount ($) Date received: Authority to fundraise sent. 4 Receipt No. BIKE No.

5 Conditions of Entry 1. The Variety office shall select those of the Applicants who are to join the V2. The criteria for selection will be as determined by the Variety Office from time to time. The Variety office shall not be required to give any reason for the non-selection of the applicant and no correspondence will be entered into. 2. All vehicles entered in the V2 Motorcycle Run must be licensed, insured and roadworthy as prescribed by State Laws. All entrants driving must have a current drivers licence throughout the event. 3. Entrants taking part in the V2 Motorcycle Run in any way must sign an indemnity disclaimer form supplied by the Variety office. 4. The entrant indemnifies Variety against any penalty or liability Variety may incur as a consequence or action of the entrant. 5. In addition to the registration fee of $550 (including GST), Entrants must procure further contributions (including donations) of at least $4500, during the year but no later than one month prior to the Run. 6. At all times entrants must abide by the rules of the road as prescribed by State laws and statutes. 7. Entrants must observe all rules and regulations and vehicle specifications issued by the Variety office. 8. All entrants must comply with the V2 Code of Conduct. 9. All entrants must read, understand and comply with the document entitled V2 Motorcycle Run Rules & Regulations / Code of Conduct & Official Conditions of Entry supplied by the Variety Office 10. Entrants are not to operate bank accounts for the purpose of fundraising, using the name of Variety, Variety V2, V2 Bike or any combination. 11. Entrants are to have all public fundraising functions approved by the Variety office. Variety fundraising rules must be strictly adhered to and applied to all fundraising by entrants. Details are outlined in the V2 Motorcycle Run Rules & Regulations / Code of Conduct & Official Conditions of Entry. 12. Variety SA reserves the right to conduct breath testing of riders for blood alcohol and drug content. 5

6 Conditions of Entry (continued) Anyone that refuses or fails to take a test will be immediately removed from the event. Anyone who exceeds the blood alcohol limit prescribed in the conditions of their drivers licence or tests positive for illegal drugs may also be immediately removed from the event. 13. Variety SA reserves the right to refuse an entrant if they believe the sponsor does not portray the image required to be associated with a children s charity. THE V2 CHAIRMAN S RULING ON ELIGIBILITIY IS FINAL. FURTHER CONDITIONS OF ENTRY MAY BE DRAWN UP BY THE ORGANISERS AND WILL BE RECORED IN THE V2 NEWSLETTER UPDATE ISSUED FROM THE VARIETY OFFICE. Variety the Children s Charity of South Australia P O Box 1235, Marleston, SA 5033 Telephone: (08) Fax: (08) Alex Richards (Event Manager) - alex@varietysa.org.au Web: 6

7 Code of Conduct (Short Form) 1. Entrants are to be aware that they will be seen as representatives of Variety South Australia and should behave accordingly. 2. Entrants will be instantly ejected from the V2 without warning, in the following circumstances: Actions that will compromise safety of the V2 entrants and the general public Detection by the Police for driving while under the influence of alcohol (over.05 or legal limit in state) or drugs Offensive behaviour on a continuous basis Assault 3. Entrants may be ejected from the V2 (for continuing transgressions) or refused entry to the next V2, after being given one warning, in the following circumstances: Bringing the name of Variety South Australia into disrepute Excessive drunkenness Tampering with other peoples cars or possessions Altering road signs or V2 signs Vandalism Refusing to obey reasonable directions of Officials or organisers 4. Any entrant ejected from the V2 will be automatically excluded from any future Variety V2 events (this includes events conducted by other states). 5. These provisions apply to all crew members and any transgression by an individual entrant will result in the exclusion of the crew as provided above. 6. Variety South Australia will not be responsible for costs incurred by early exclusion from the V2. 7. Above all, remember that the entrants are representatives of a CHILDREN S CHARITY. 7

Work Phone: I am happy for my contact number and address to be circulated to other Variety entrants? Work Phone:

Work Phone: I am happy for my contact number and address to be circulated to other Variety entrants? Work Phone: 2019 4WD Adventure: Parachilna to Laura 6-12 April 2019 Team Registration Form Primary Contact (Crew Captain): Car Number Crew Member #1: Crew Member #2: Crew Member #3: Vehicle Details Make: Model: Year: