give someone the ride of their dreams

Please make sure to read and understand the Entrant Regulations which can be found here before completing the Driver Registration Form.

Personal Information

First Name

Last Name

Preferred Name

Used on the day

Contact Mobile Phone

Mobile phone only please

Email Address

Confirm Email Address

Mailing Address

Drivers License Number

License Expiry Date

License issued in

Date Of Birth

Do you have a police clearance?

Yes No

Vehicle Information

Make

Model

Colour

Rego Number

Insurance Company

Number of passenger seats in your vehicle

Does the vehicle mentioned above have safety belts?

Yes No

I am willing to have a participant with intellectual needs travel in my vehicle with me for the purpose of the event:

Yes No

If the Submit button is not active, please check that your email address is correct

Please write or call us with your questions or comments about Dreamride Australia 2020

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