Registration

A non refundable entry fee of $200 is required and will be donated to the No Liver No Life Aust Inc. organisation. A $1900 fee will be required for participation in the event. *A $800 fundraising amount donation to the Australian Liver Foundation. All donations are tax deductible and ALL profits will be donated to the Australian Liver Foundation.

Note: *means required entry. (If you are making a booking, please ensure you complete all sections of the form)

 

Drivers names*
Passengers names*
Number of children
Ages of children
   
Postal address*
Suburb or Town*
State*
Postcode*
   
Vehicle make*
Vehicle model
Registration number
Camper trailer
Camper trailer registration
   
Email address*
Confirm email address*
Contact (land line) phone*
Contact mobile phone*
   
Additional comment/questions
   
Method of payment