USTA Registration

Join us for the 2007 World Driving Championship

Andy Miller Will Represent The US

Don't Miss This Exciting Opportunity!


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		Valid proof of citizenship requires a valid state issued ID (such as a drivers license) AND a passport. * Required Fields

Passenger #1

Passenger #2

Last Name as on your proof of citizenship *

First Name as on your proof of citizenship *

Preferred First Name

Note: If you will be sharing as a triple or a quad please fill out another registration form and note on both your sharing preference.

Address Information

Street Address *

City *

State *

Zip Code *

Home Phone *

Cell Phone

Email Address *

Pricing Information

Package *		$ 3,970.00 Per Person - Based upon double occupancy, standard room
		$ 5,125.00 Per Person - Based upon double occupancy, Jr. Suite
		$ 5,207.00 Per Person - Single occupancy supplement, standard room

Rates are land only per person based on double occupancy and include the following: 5 Star hotel nightly, Airport transfers, All motorcoach transfers, Porterage, breakfast daily, gratuities for drivers and escort, welcome dinner, admissions to Ashcombe Maze, Wine Tasting at Stonier Winery, Red Hill Winery lunch and beverage package, Cranbourne racing, admission, program dinner and beverage, coach transfer to Moonee Valley racing, admission, program, dinner and beverage, Maryborough racing, admission, program, dinner and beverage, Flight to Christchurch, transfers, Antarctic Centre, Hagland ride and lunch, Addington racing, admission, program, dinner and beverage, Nevele R. Stud Farm, USTA Cocktail party.

Please note we have group air pricing secured via Air New Zealand in and out of Los Angeles.

*We will phone you to confirm your air schedule.*		$ 1,128.50 Per Person - Coach Class
		$ 2,540.00Per Person - Premium Class Limited availability Request only.
Aircraft seating: Can be view by clicking link below http://erequest.airnz.co.nz/nz/explore/explore_flh.htm

Trip Cancellation Insurance *	Yes	Trip cancellation insurance is available and highly recommended. We will contact you.
	No

Room Requests

Special Occasion?

Share request for third or fourth
Miscellaneous Requests

Payment Information

Passenger 1 Passenger 2

Deposit Amount *

(Deposit is non-refundable)

Credit Card Type *

Credit Card Number *
Expiration Date (MM/YY) *

3 Digit Security Code*

Emergency Contact

Emergency Contact Name * #1
Emergency Contact Phone * #1	(ex:818-555-5555)

Emergency Contact Name * #2

Emergency Contact Phone * #2

(ex:818-555-5555)


You mail also print and fax this form to 419-841-1180 or call with your information 800-776-2852