St Trial 12 – 13 May (Closing date 8/5) 2nd Trial 26 – 27 May (Closing date 22/5) 3rd Trial

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1st Trial 12 – 13 May (Closing date 8/5) 2nd Trial 26 – 27 May (Closing date 22/5)

3rd Trial 9 – 10 June (Closing date 5/6) 4th Trial 28 – 29 July (Closing date 24/7)

WP Champs 10 – 12 August (Closing date 7/8)

Surname: __________________________ First Name: _________________________

Address: __________________________

__________________________ Code: _______________________________

E-Mail: ___________________________________________________________________

Tele: __________________________ Cell: _______________________________

Age: (1/1/07) __________________________ Birth Date: _________________________

ID Number: __________________________
Amount Pd: __________________________ Manner Paid (e.g. Absa) ______________

One Division: WP Fee R110, Plus R55 per trial, plus WP Champs R90 or R390 for the year

Pro Divison: WP Fee R135, Plus R80 per trial, plus WP Champs R110 or R530 for the year
Two Divisions: WP Fee R110, Plus R110 per trial, plus WP Champs R180 or R680 for the year
Pro & Division: WP Fee R135, Plus R135 per trial, plus WP Champs R200 or R810 for the year
Internet payments: ABSA BANK – TABLEVIEW,

ACC No: 9014949369, BRANCH 632005


PRO Open to anyone Juniors 15 – 17 & under on 1 Jan 07

DK Open to anyone Men 18 or older on 1 Jan 07

Masters Older than 28 Ladies All women

Boys 14 & under on 1/1/07
I hereby make formal application to enter the WPBA Trials and Championships, and agree to abide by the decision of the judges and the organizers. Furthermore, in consideration of your acceptance of my application, I hereby release the sponsors, their members or agents and any officials connected with this competition from all liability for injuries or damages whatsoever arising from my participation or presence at this competition and also agree to promote their products for the duration of these events. Release is inclusive of photographs and moving pictures.
APPLICANTS SIGNATURE___________________________________________________
PARENT / GUARDIAN SIGNATURE (if you are under 21) __________________________

Chairman: Angus Houston 0829205311 Rider Rep: Ian Kruger 0825943082

Treasurer: Anmari Bassett 0824635704 Contest Dir: Jamie Higgins 0722362788
FAX ENTRIES TO: 021 932 3264

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