Entry Details
Entry fees must accompany your entry - All enquiries: info@eastcoastclassic.com.au
Male Name*
Female Name*
Studio/Coach
Postal Address
Suburb
Postcode
State/Country*	- VIC NSW QLD TAS SA WA ACT NT NZ Other
Email*
Phone*
Event Numbers
	[Please list your event numbers as per the syllabus, separated by a comma (eg: 1,5,33)]
	[Pro/Am Entry forms can be found in the download section]
Tickets
Saturday 5th November         Reserved Floorside Table for Day Session only and General Admission to Evening Session Adult Adult $84 Qty Child/Aged Pensioner Child/Aged Pensioner $64 Qty   General Admission for Day/Night Adult Adult $69 Qty Child/Aged Pensioners Child/Aged Pensioners $49 Qty   General Admission for Night Session from 6.30pm Adult Adult $39 Qty Child/Aged Pensioner Child/Aged Pensioners $29 Qty   East Coast Ball 2 course meal (inc. Daytime GA) East Coast Ball $145 Qty 2 course meal (inc Daytime Reeserved) East Coast Ball $160 Qty         Sunday 6th November               Table seat for Day/Night Sessions Adult Adult $84 Qty Child/Aged Pensioner Child/Aged Pensioners $64 Qty         General Admission for Day/Night Adult Adult $69 Qty Child/Aged Pensioner Child/Aged Pensioners $49 Qty         General Admission from 6.30pm Adult Adult $39 Qty Child/Aged Pensioner Child/Aged Pensioners $29 Qty         Late Entry Fee from 17th September Late Entry $25 Qty         Video Licence       Single Day - Saturday Video (Sat)$20 Qty Single Day - Sunday Video (Sun) $20 Qty Both Days - Sat/Sun Video (Sat/Sun) $30 Qty         Credit Card Processing Fee Credit Card Processing Fee $5 $5
Payment
Credit Card Type - Visa Mastercard Credit Card Number Credit Card Expiry Cardholders Name Amount