REGISTRATION FORM  
 For More information contact: Steve Kernot, 027 2814433 safari@kc4wd.co.nz

  Required: Names, Phones, Email, Emergency Phone Numbers
Names
Address
Phones
Email
Vehicle - Make, Model & Plate
Number of Adults
Number of under 12s
Number of under 5s
Medical Conditions
Special food requirements
Emergency Phone Numbers
NZ4WD Association Affiliation Number
Type of tyres, Road, AT, Mud
  Road AT (All Terrain) Mud
 

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