Paper Application: The 2011 Collingwood Street Trolley Derby
This print-friendly page is for those who can't apply online
I have read and agree to the 2011 Trolley Derby Rules & Regulations
I am over the age of 18 and have the legal authority to enter all drivers listed below
I am aware that Trolley Racing might cause me injury and/or damage to my property
I wish to take part in the Trolley Derby despite these risks
| Signature: | ________________________ |
| Postal Address: | ________________________ |
| ________________________ | |
| ________________________ | |
| Email: | ________________________ |
| Phone (daytimes): | ________________________ |
| Phone (evenings): | ________________________ |
| Mobile: | ________________________ |
| Fax: | ________________________ |
| My/our Trolley is called: | ________________________ |
| I/we want to enter our trolley in the following grade(s): | |
| Nippers (born 2004 to 2009): | |
| Drivers Name: | ________________________________________________ |
| Drivers Name: | ________________________________________________ |
| One of the following three grades: | |
| Zoomers (born 2000 to 2003): | |
| Drivers Name: | ________________________________________________ |
| Drivers Name: | ________________________________________________ |
| Sprinters (born 1996 to 1999): | |
| Drivers Name: | ________________________________________________ |
| Drivers Name: | ________________________________________________ |
| Rockets (born 1891 to 1995): | |
| Drivers Name: | ________________________________________________ |
| Drivers Name: | ________________________________________________ |
| Monarchs (born 1891 to 1995): | |
| Drivers Name: | ________________________________________________ |
- Post to:
- Nelson Summer Festival
Nelson City Council
PO Box 645, Nelson - Fax to:
- 03 546 0239
- Deliver to:
- Ground Floor Reception
Nelson City Council,
Trafalgar Street,
Nelson
