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2008 Online Officials Registration Form

Please fill out and submit this form to register as an official of the 2008 Rally SA. Questions marked in bold are compulsory

Contact Information
Title:	Dr Mr Mrs Ms Miss Choose	Home Phone:
Firstname:		Work Phone:
Surname:		Fax:
Address:		Mobile:
Suburb:		Email:
State, Postcode	ACT NSW NT QLD SA TAS VIC WA	Please provide at least one contact number.
Occupation:
Age:	Under 18? Yes No	Date of Birth: (must be completed if U18)
Would you prefer a Beanie or Cap?:	Beanie Cap Choose
Car Club Member:	Yes No If yes, which club?
*Can you be contacted to assist with other Events? Yes No

Experience & Preferred Role:

Have you been contacted for the 2008 event?		Yes No
If yes, by whom (Stage Commander/Senior Official)
For Role:	Location:
Previous Rally Official Experience:
Rally SA:	Yes No  If yes which years?
Classic Adelaide:	Yes No  If yes which years?
Other:	Yes No  If yes what experience?
2007 Rally SA Official Experience:
2007 Role:		Stage Commander/Location
What role would you prefer in 2008? Please Choose Stage Team - Control Official Stage Team - Road Closure Service Park Forties Spectator Area Parc Ferme / Start HQ & Documentation Scrutiny WICEN Scoring / Results Equipment Course Cars Car Wash Data Entry FIV - Medical FIV - Fire Refuel - Fire Commentary Other Other:
Do you have a preferred location for 2008?		Yes No  If yes where?
Do you want to be placed with other officials?		Yes No  If yes who?

Availability

Please select the days that you are available: (NOTE: Daytime Hours Only unless indicated)

Activity	Pre Event	Test Day	Test Day	Test Day	Recce	Recce	Media Day	Rally Start	Event	Event	Post Event
Date		Tues 22 July	Wed 23 July	Thurs 24 July	Thurs 24 July	Friday 25 July	Friday 25 July	Fri Night 25 July	Sat 26 July	Sun 27 July	Mon 28 - 31 July

Additional Information

Are you a CAMS Licenced Official?: Yes No Your CAMS Licence Details: CAMS Licence Number    CAMS Licence Types     Expiry Date of Cams Licence (eg. December 2008)   Do you intend to camp out in the forest on Rally Weekend? Yes No Are you familiar with A to A timing? Yes No

Emergency Information
Contact:	Name:
	Relationship:
	Phone:
Medical:	(a) Do you suffer from any pre-existing medical conditions we need to be aware of? Yes No If yes, please provide details (b) Are you presently on any medication we need to be aware of? Yes No If yes, please provide details (c) Do you suffer from any allergies we need to be aware of? Yes No If yes, please provide details

Privacy Statement All information supplied on this form will be entered into a database for the purposes of managing the Rally SA and will not be disclosed to third parties without the specific consent of the person concerned. (please refer to tick box*)