Each month you go in the draw to win either a copy of Robin Judkins “Mad Dogs” or Kelly Barbers “Conquering the Speight’s Coast to Coast”. Please complete the form ensuring that the mandatory fields * are populated. First Name:* Last Name:* Birth Date:* 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 (dd/mm/yyyy) Address:   City: Zip or Postcode: Click here to find your NZ postcode Country: Phone: (e.g. 03 5555555) Mobile: E-Mail:* Promotional Code: Where did your hear about the Speight's Coast to Coast? What will motivate you to compete in the "Speight's Coast to Coast? Comments: