PUNTERS CHALLENGE 2021
ENTRY FORM 

Wellington Racing Club Punters Challenge May 2021
Name:*
Address:
Contact Number:*
Email address:*
Team / Club /Table name:*
Please indicate names of other team members (if applicable)
Name 2:
Name 3:
Name 4:
Name 5:
Please indicate if you would like a table on your own or share with another team and we will endeavour to accommodate
or Share with (team name or organiser)
Please indicate if any special dietary requirements
ENTRY FEE: $80 per person. Sub-total =
BETTING FUND: $720
Total to pay:
Payment


For Credit Card payments: Please supply number (Visa or Mastercard only)
Credit card expiry date (MM/YY)
Name on Credit card
Please note: 2.7% surcharge will apply to any payments made using a credit card which is in line with our cost of acceptance.
Please note that you may phone the WRC on 04 528 9611 to provide your credit card details verbally or to arrange other payment methods
Any further comments
ALL ENTRIES & FUNDS MUST BE RECEIVED BY NO LATER THAN 5pm THURSDAY 27 MAY 2021. LATE ENTRIES ACCEPTED ONLY AT CLUB DISCRETION
We look forward to seeing you at Trentham early on the 29th May (You should get an automatic email letting you know we have your entry)