2015 STREET STOCK PERPETUAL NOMINATION FORM – 28th March, 2015 NAME CLUB ADDRESS CAR # EMAIL MOBILE # INSURANCE TYPE INSURANCE # CAR MAKE CAR MODEL DO YOU REQUIRE TO HIRE A TRANSPONDER – YES or NO (please circle) IF NO – YOUR TRANSPONDER # ................. (To save time on race night, it’s important that we know your number in advance please) SPONSORS TRAVEL DOLLARS PAID – Maximum $250 paid out per driver From South of Perth $250 Perth $200 Geraldton $150 Shark Bay $ 80 Karratha $150 Port Hedland $200 Broome Nomination Fee : $ Nil (gate admission to be paid by non-members) Transponder Hire Fee : $10.00 (to be paid by non-members) $250 Late Nominations : Run rear of field th Nominations Close : 24 March, 2015 Send Nominations : via email [email protected] or fax 99 411 287 RULES and REGULATIONS Carnarvon Speedway Club (Inc) runs under the ASCF Speedway Sedans Australia racing rules, regulations and code of conduct. If there should be any unforeseen circumstances that cause stoppage of this event, the Carnarvon Speedway Club Executive Committee shall make the final decision in regards to allocation of prizes, money and trophies. Complimentary BBQ, trophy and travel money presentations will be held in the club house at the completion of racing – all welcome Camping and hot showers available at the track A minimum of 5 nominated race cars are required to host this event Scrutineering commences 4.30pm Drivers briefing 6.30pm Racing commences 7.00pm I HEREBY AGREE TO ABIDE BY THE CARNARVON SPEEDWAY CLUB (INC) RULES AND REGULATIONS AND ALL DECISIONS MADE BY THE APPOINTED OFFICIALS AND COMMITTEE. Signed__________________________________________________________________ (to be signed by both driver and parent/guardian if under the age of 18) President Vice Pres Secretary Secretary Treasurer Wade Mason 0409 276 933 Lance Root 0437 485 991 Leticia Moorfoot 0432 743 909 Tammy Chapman 0429 871 283 Paula Mogg 0408 913 166 Proudly sponsored by CARNARVON GLASS and WINDOW TINT Dated______/______/______