Early Registration Form

RENAULT Sport & A lpine EXPO*

Brisbane – 9 July to 25 July 2010
* RSAE is proudly organised by the Renault Car Club of Queensland Inc.
S
Registrant Information: All mailings concerning the RSAE will be sent to you at the
addresses provided below: Please print in BLOCK LETTERS.

Name: (Surname Last)

Preferred Name for Name Tag:
Club Affiliation:
Address:
Address Line 2:
City, State, Postcode:
Country:
Daytime Phone & Fax No.:
Mobile Phone No.:
Email address:
I shall be accompanied by the following people
(include preferred name for name tag in brackets if different):

I shall be exhibiting:
(Please use the form on the final page to provide more complete vehicle information.)

Accommodation in Brisbane
We have made arrangements and negotiated special rates for RSAE entrants and friends at:
Comfort Inn Robertson Gardens, 281 Kessels Road, ROBERTSON QLD 4109
Ph. 61 7 3875 1999, Fax 61 7 3274 1428, TOLL FREE – 1800 777 374
Email – accom@robertsongardens.com.au
This venue is a favourite of the motor racing fraternity. The RSAE Welcome Function and RSAE
Gala Dinner will be held here and this property has been awarded ‘Official RSAE Motel’ status.
Please ask for Gloria and mention RCCQ and RSAE when booking to obtain the special
discounts.
Alternatively a nearby motel is the:
Sunnybank Star Motel, Cnr. Padstow & Warrigal Roads, EIGHT MILE PLAINS, QLD 4113
Ph. 61 7 3341 7488, Fax 61 7 3341 7630, TOLL FREE – 1800 639 298
Email – sunstar@ats.com.au
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Registration Fees:

Early RSAE Registration - $130.00 for car and driver, additional persons $95
Early RSAE Registration is available until 15 April and includes the following activities:
1. Admission to the RSAE Welcome Function on Friday night, 9 July 2010 plus two drinks.
2. RSAE Day Run entry for one car on Saturday 10 July 2010
3. Gala Dinner for one including welcome drink.
4. Entry fee for the Grand Display of French Cars on Sunday 11 July 2010.
5. Personal name tags and car display cards.
6. Sunday Casual Dinner for one
Note: The cost of additional drinks at meals is NOT included.

My party will comprise car and driver $130

plus people at $95 each
Sub Total
RSAE Polo Shirts
A limited number of specially designed RSAE polo shirts will be available at a cost of $40 each.
Don’t miss out! Pre-order yours now by nominating numbers and sizes below:

Number Male/Female Size – S, M, L, XL, XXL, Other Cost @ $40 each

Sub Total

GRAND TOTAL ……………………...

Please complete all pages and return with registration fees to:

RENAULT Car Club of Queensland Inc.

Box 1155
Milton QLD 4064

Alternatively, email the forms to: - enquiry@renaultclubqld.com.au

Please make out cheques in favour of ‘Renault Car Club of Queensland Inc.’
Or pay by direct payment to the RCCQ account at: BSB – 124 018, Account No. 10489227

I enclose a cheque/Money Order for $.......................

Or
I deposited payment into the RCCQ account as per details below.
Please make sure that we know who has paid and what the payment is for!
Amount Paid Date Paid Payment Reference
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Please assist us to plan the additional activities for RSAE – 2010.

Please indicate your interest by ticking the boxes below:

Activity Interested?
(Y/N)
Mon. 12 July – Track Day: A sprint event at a motor racing circuit.
Tue. 13 to Fri. 16 July – Transit to Sydney along some interesting
back roads creating the opportunity to attend the Sydney French
Car Day.
I would prefer my ‘Roadbook’ for the Sydney trip to give distances
in miles.
Runs at hill-climb tracks at Grafton and Kempsey
Sunday 18 July – Sydney All French Car Day.
More driving excursions for those returning to Queensland, using
a different route for a real Australian outback experience.

More Information? If you need more information on any aspect of the event,
please contact us at the above addresses.

<Room for your comments if needed>

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RSAE Car Details

Please provide as much information as you easily can.
It is not necessary to complete all details.

Registrant’s Name
Vehicle Model
Year, Colour
Rego. No.
Description

Chassis/Engine Number
Engine Configuration
Engine Size (cc)
No. of Cylinders
Bore (mm)
Stroke (mm)
Carburettor/Injection
details?
Petrol or diesel?
Turbo, Supercharged?
Power…….@.......RPM
Torque.…..@.......RPM
Tyre Size F. R.
Rim Size F. R.
Top Speed
Standing 400m, 1000m
Fuel Capacity
Brake Size
Wheelbase
Track F. R.
Length
Width
Height
Mass
Modifications, Anecdotes
(Use additional page
if required)

See you at the best RENAULT event in Australia ever.