Event Booking Form

Print out this page, enter your details clearly, and post or FAX it back to us, together with your Credit Card Details or a deposit cheque of  €20 per competitor (minimum €200 )

Before submitting your application, check the date availability on 056 - 7768914   or   087 - 2464872

Name of Organiser

Name of Group

Contact Address

Telephone

Fax Number

e-mail address

Event Selected

Date Selected              /             /

Arrival Time at Circuit          :

Number of Participants

Tell us if this a special occasion?

N.B. A deposit of €20 per participant is required at time of booking

DEPOSIT DETAILS

tick box below as appropriate

Deposit paid

           €             :

Cheque

Postal Order

Cash

Credit Card

see below
Card Number        Q!!!-A  !-!!! -!!!! Expiry Date          QQ-QQ

Signature

Application Date

           /           / 

Return the completed form, with your deposit or Credit Card Details, to :- 

by post:     KILTORCAN RACEWAY,  KILTORCAN,  BALLYHALE,  CO. KILKENNY.

or by Fax:     +353 - (0)56 - 7768914