EmailMe Form - Targa Sixty Six Registration Form 2018

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Entrant's Name *

First Last

Second Driver Name

First Last

Email *

Confirm

Emergency Contact At The Track

First Last

Phone

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Cars attending: YEAR, MAKE & MODEL

Car 1
Car 2
Car 3
Car 4

Family/Crew Name 1

Family/Crew Name 2

Family/Crew Name 3

Membership includes passes for 4 people total. Driver plus 3.

Overcrew. $45 per person for the weekend.
Does not include lunches.

Over Crew Name
Over Crew Name
Over Crew Name
Over Crew Name
Over Crew Name
Over Crew Name

Please fill out the fields below.

Primary Membership $2,300. Includes lunch each day for 2.

Additional Lunches $25 per plate.

Dinner $125 per plate.

Membership includes 2 lunches each day Friday, Saturday & Sunday.

Primary membership includes driving privileges for 2 family members. *

Targa Primary Membership@$2,300
Overcrew@$45
Extra Lunches Friday@$25
Extra Lunches Saturday@$25
Extra Lunches Sunday@$25
Total Saturday VIP Dinners@$125

Primary Membership $2,300. Lunches $25 per plate. Dinner. $125 per plate. Overcrew $45.

Saturday VIP Dinner.
Please select entree choice:

Guest 1
Guest 2
Guest 3
Guest 4

$125 per plate for 3 course meal with reception, beer & wine.

Price

$ Dollars . Cents

If paying by check please make out to Intercontinental Events Inc.
Mail to:
Targa Sixty Six c/o Trish Mazzoni
950 Greenbriar Drive
Boynton Beach, FL 33435