Register - 2021 Geelong Convoy

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Kickstart Fundraising

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Personal Details

First Name *

Last Name *

Email Address *

Password *

Mobile *

Date of birth *

Gender *

Male Female Other

Postal Address *

(enter address manually)

State

Country

Emergency Contact Details

Please note this needs to be someone who is NOT attending Motocyc with you

First Name *

Last Name *

Contact Number *

Relationship to you

Have you participated in Convoy before? *

Yes
No

TRUCK OR BIKE DETAILS

Truck or Bike Make *

Truck or Bike Registration Number *

Truck or Bike Insurance Policy Number *

Do you have a valid Heavy Vehicle or Motorcycle Licence? *

Yes
No

Drivers Licence Expiry Date *

Drivers Licence Number *

MERCHANDISE

What size polo shirt are you? *

IMPORTANT DETAILS

Please list any medical conditions or allergies, including medication

I acknowledge that I have read and understood the terms and conditions of the event Indemnity and Fundraising Terms and Conditions I agree to be bound by these terms.

I have read and understand the Code of Conduct

Geelong Convoy Registration

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Personal Details

Postal Address *

Emergency Contact Details

From the heart of the Camp Quality family

Call our hotline 1300 662 267

Geelong Convoy Registration

Create Account

Already have an Account

Already have an Account with us?

Personal Details

Postal Address *

Emergency Contact Details

From the heart of the Camp Quality family

CONNECT WITH US

Call our hotline 1300 662 267