Entrant's Name.................................................................................................................

Address.............................................................................................................................

Contact Phone Number.....................................................................................................

Club/s.................................................................................................................................

Rally Vehicle - Make...................................Model...........................Year.......................
.
Vehicle Registration No............................………………...............................................

Adult Passengers Names,			Children Names & age as at Rally Date.   								 
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I certify that the vehicle entered is on full registration, limited or annual permit to move and that the vehicle is road worthy and covered by third party property damage insurance.  I agree to abide by the regulations of the Rally and all instructions from the Rally Director and Officials and to accept these decisions as final.  I also agree that HETCC Vic Inc, its committee, its sponsors will in no way be held responsible for loss of or damage to the vehicles, parts or accessories.  The entrant and passengers hereby waive the right of action against the HETCC Vic Inc its committee or agents.

I also accept that the officials of the Club reserve the right to exclude any entrant from further activities associated with the Rally should that entrant his/her passengers conduct themselves in a manner detrimental to the motoring cause.

Signed.........................................................Date...…./.…../2010. 			PTO
 

The following information is required by the Rally organisers and the answers to all questions will remain confidential.  Please complete and elaborate as appropriate for all those travelling in your party:
·	Do you have any physical activity restrictions? (stairs, walking distance restrictions) etc. …...........................................................................................................................................…....….
·	Do you require special motel room access and facilities?.......................................................…......
·	If available, would you like a room with a spa?…………………………………………….….…..
·	Do you have any special meal requirements?......................................................................…..........
·	Will you require car trailer facilities?………………………………………………………....…....

Accommodation.	Country Comfort Warrnambool, 525 Raglan Parade Warrnambool VIC.

The Country Comfort Warrnambool is in an ideal location - easy access to everything, large off street parking and safe drive out exit route. Elements Restaurant and Bar is open for dinner, Monday to Saturday and breakfast is available for guests daily.  Discounted breakfast - hot and cold buffet and dinner room service is also offered as well as 24 hour reception, wireless broadband internet access, Austar with movie and sports channels, guest laundry facilities, outdoor swimming pool and complimentary parking.  
The Quality Inn is just a short walk to shops, restaurants, fast food outlets and some of Warrnambool's tourist attractions.  We have reserved all their available rooms which will be allocated on a first in basis.  Should we run out of rooms, you will be accommodated at another Motel next door.  The room tariff is heavily discounted off the normal rack room rates for this peak season. 

Room Rates per night	Rally Dinner per Head
Single/Double                                         $ 95.00	Adult	(3 Course meal)	.	           $42
Extra Adult                                              $22.00    	Child size from Adult menu.                  $30
Child 15 years and under                        $ 15.00	Child Menu - Fish/Nuggets & Chips etc.  $15
Quad rooms may be available.  Pleasecheck with Rally organisers                                                    	
	

We require the following monies with your rally entry form:

Rally Entry Fee.............................................................................................$ 70
No of people per Room.....................		Deposit per room......	$100 
			         (write in no.)

Rally Dinner Friday 1st October 2010.

No of Adult Meals.................................. @ $42	 =	$
No of Child size from Adult menu................... @ $30        =	$
No of Child Meals................................... @ $15	 =	$...............

TOTAL RALLY DEPOSIT PAYABLE					$...............

Cheques to be made payable to - HETCC Vic Inc.
Post cheque together completed and signed Rally Entry form BEFORE 11th June 2010 to - HETCC Vic Inc, 216 Ryans Road, Eltham North, Victoria, 3095.  Telephone enquires to Phil Haxby Ph. (03) 9439 2585 (AH).  Email hetrules@yahoo.com.au.