Event Booking Form

Print this page, enter your details clearly, and post it, with your deposit cheque,
or FAX it, with your Credit Card Details, to us.  Deposit must be for  €25 per competitor (minimum €250 )

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