Klerksdorp Aerodrome

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ENTRY FORM - KOSH CANNONBALL 2008
Name & Surname:  
Address:  
   
   
Cell:  
Tel:  
Fax:  
e-mail:  
Vehicle Make:  
Class:  
Vehicle Registration:  
Blood Group:  
   
Date:  
Signature:  

 

NOTICE TO ENTRANTS

  • Only pre-entered competitors will be allowed to race on race day

  • Indemnities must be signed before going onto the track

  • Entrance fee per car: R50.00

  • Payment to be made to:

  • KLERKSDORP PILOT ASSOCIATION

  • ABSA BANK

  • BRANCH CODE: 334 338

  • ACC. NUMBER: 405 635 1584

  • YOUR REF NO. ON PAYMENT: VEHICLE REG. NO. & INITIAL & SURNAME

  • FAX PROOF OF DEPOSIT TO: 018 462 5414

 

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