Registration of interest form

Name ( given names will be on name badge)

FamilyGiven

 

Postal Address

Street SuburbState Postcode

 

Phone Numbers

Home Work Mobile

 

Email

 

Principle Motorcycling Club ( for name badge)

 

BSA No 1 ( also on name badge)

Year 1 Model Number 1 Model Name 1 Plate 1

BSA No 2

Yaer 2 Model Number 2 Model Name 2 Plate 2

BSA No 3

Year 3 Model Number 3 Model name 3 Plate 3

Arrival dayArrival time Departure day Departure time

Pillion Passenger Pillion, Family Name Given Name

Runs, Please indicate how many people will be attending each run, including rider , pillion & children, 0 = not going and which type of run

Saturday Lunch Sunday breakfast Sunday Lunch Monday

Accomodation

Please note that the above information shall be used solely for the purpose of administration of the BSA National Rallies and shall not be on sold to any commercial interest nor used by any of the participating clubs for any reason except those pertaining to the runing of the present and future BSA National Rallies. Only your name, postal address & contact detail shall be retained, motorcycle & pillion details will be deleted upon the conclusion of the current rally

.If you object to the BSA Clubs retaining this information please indicate here

 

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