First name |
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Surname |
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Your age |
(We need this to get an average - for media purposes) |
Address |
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Suburb/Town |
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Postcode |
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Phone |
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Email |
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Will you participating
in the Scootaville
event? |
If no, click here.
If Yes - continue.
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Are you a
Pensioner? |
(We need to know this to get
group bookings for some destinations and train travel). |
Are you ex or
serving ADF |
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Which Service?
(Leave blank if N/A) |
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If not ex-ADF, what organisation do
you represent |
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Are you a TPI/EDI? |
(We need to know this to get
group bookings for some destinations and train travel). |
So we can
arrange power for those requiring ResMed devices or similar in
order to sleep, please indicate if you will require power at night.
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Do you wish to
be a rider, a supporter or a tag alonger |
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If a Tag-along,
please provide the names of all people travelling with you.
Please note all persons must pay the entry fee ($200). |
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If a supporter
how can you assist |
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If supporter, are you able to
provide a support vehicle |
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If so - what?
(Leave blank if N/A) |
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Have you ever
ridden a moped or motor bike? |
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Do you have a
motor bike licence |
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Have you
arranged for someone to be your bike buddy? |
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If so - who? |
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Do you wish us to arrange train travel for
your return to Brisbane?
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Comments |
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