Register your Motoring FundraiserMotoring Event Entrant DetailsPrimary ContactFirst Name*Last Name*Address* Street Address Address Line 2 City State Australian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia Postcode Email Address* Mobile Number*Variety Event*Please select which event you are fundraising forSA Variety BashVariety 4WD AdventureVariety Moto RunCar/Bike Number*Fundraiser DetailsFundraising Event Name*Start Date* Date Format: MM slash DD slash YYYY End Date* Date Format: MM slash DD slash YYYY Location*Where will the event / activity take place?Venue*Venue Address Street Address Address Line 2 City Australian Capital TerritoryNorthern TerritoryNew South WalesQueenslandSouth AustraliaTasmaniaVictoriaWestern Australia State Postcode Type of Event*Please provide a description of the event / activity, including a budget showing expected revenue and expenses*Expected number of attendees or expected sales*Is there a ticket price?*YesNoN/AHow much will tickets cost?*Will you be producing any advertising material inc: registration forms, posters etc?*YesNoRafflesAre any raffles being conducted?*YesNoPrice of raffle tickets*Number of tickets available*InsuranceDo you require this event / activity to be covered by Variety SA Inc. Public Liability Insurance?*Please note if Public Liability Insurance is required, please email [email protected]YesNoOther SupportDo you need to borrow any Variety flying banners, pull-up banners, corflutes or eftpos machine?*YesNoPlease note: these may already be in use by other supporters. Please contact reception at the Variety SA office on (08) 8293 8744 to book.Please include any other relevent points of informationDisclaimer*The answers provided to the questions above are true and correct. I will notify Variety South Australia Incorporated of any changes to the event that will have an impact on any of the above questions. I agree to the Variety SA Fundraising terms and conditions I am aware that I must complete the Event Reconciliation Form in order for the funds raised to be attributed to my car / bikeCAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
