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NZ Supercross Championship - Final Round
Coopers Property, Ryan Road, Winton
Saturday 15th December 2018
for available class details.
Note: You must hold or upgrade to a MNZ Championship licence to be eligible to compete in Championship classes,
or if holding a MNZ Club licence you may apply for a Championship Special Event Licence Upgrade (valid for one event only within Licence season)
If competing in a Championship class you must meet minimum number of event requirements (3 Senior/6 Junior) refer sup regs
Mini Demonstration classes can enter on a MNZ Club licence or purchase a One Event Licence for $30.00.
Demonstration Pit Bike Class - Class regretfully cancelled due insufficient entries
SX Lite - Class regretfully cancelled due insufficent entries
Please submit a seperate entry for each competitor.
Indicates required field
Class entered (please select from dropdown box)
SX1 (151 to open 2 stroke & 251 to open 4 stroke)
SX2 (126cc 2 stroke & 250cc 4 stroke)
SX Lite - CLASS CANCELLED (90 to 150cc 2 stroke only)
Junior Lite 11-16 years (60-85cc 2 stroke & 100-150cc 4 stroke)
Junior 250 12-16 years (90cc to 125cc 2 stroke & 151 to 250cc 4 stroke 14-16yrs)
Demonstration 7-11 yrs Pro 65cc
Demonstration Junior 8-10 yrs (50-85cc 2 stroke / 100-150cc 4 stroke)
Demonstration Mini 4-8 yrs 50cc (any 50cc bike)
Demonstration - Pit Bike - CLASS CANCELLED (Senior only) up to 160cc
Junior 250 (Minimum 14 years to compete on 160-250cc 4 stroke)
Machine & Capacity
Date of birth
Age on race day
2nd Class Race Number
2nd Class entered
SX1 (151cc to open 2 stroke & 251 to open 4 stroke)
SX2 (126-150cc 2 stroke & 250cc 4 stroke)
SX Lite (90-150cc 2 stroke only)
Junior Lite 11-16 years (60-85cc 2 stroke & 100-150cc 4 stroke)
Junior 250 12-16 years (90cc to 125cc 2 stroke & up to 250cc 4 stroke 14-16yrs)
2nd Class Machine & Capacity
MNZ Licence # (Include CH or CL infront of lic nbr or OE if in demonstration class & require a One Event Licence)
Championship Classes - $90.00
Pit Bike Class - Entry fee $20.00
Demonstration Class - Free (No Transponders)
Championship Special Event Upgrade Licence - $50.00
Own Transponder (provide pin number) Deduct $5
One Event Licence (Demonstration classes only) - $30.00
Intended Payment Method
Cheque Being Sent
Total Payment $
Competitor Sponsors (limit 6)
Any questions regarding this event, please refer to s
for contact details of club officials.
DISCLAIMER OF LIABILITY:
To Southland Motorcycle Club, and Motorcycling New Zealand Inc
1. I have read the Supplementary Regulations* for this Competition and agree to be bound by them and the Manual of Motorcycle Sport, the MNZ Constitution, and the MNZ Code of Conduct.
* Supplementary Regulations also available at www.timingtech.co.nz
2. I am aware that the sport of Motorcycle Competition might a) cause me injury; serious or otherwise b) damage my property.
3. I wish to take part in the NZ Supercross Championship Final Round despite the above risks.
4. Neither I, or anyone associated or connected with me will make any claim against you or your officers, employees or agents in respect of: a) any injury suffered by me; or b) any damage to any of my property regardless of how the injury or damage occurs.
5. I will indemnify you against all claims, damages or losses (including costs) which you incur as the direct or indirect result of any injury to me or damage to my property.
6. I am physically fit and there is no health or other reason why I should not participate in the sport of Motorcycle Competition.
7. I am aware that this disclaimer will not affect any legal obligations you have to me which you cannot contract out of under NZ Law.
8. I agree that in this disclaimer “my property” includes any property owned by me or in my possession or under my control.
9. I agree that this disclaimer will be binding on my family, my heirs, my legal assigns and my administrators and executors.
10. I accept that stripping and re-assembly for Technical Checks are at my cost.
11. I consent to the details contained in this form being held by the Southland Motorcycle Club for the purpose of the promotion and the benefit of the race meeting concerned, and Motorcycling in general. I acknowledge my right to access and correction of this information. The consent is given in accordance with the Privacy Act 1993.
12. MNZ supports the FIM/IOC Charter on drugs in Sport. MNZ uses the services of Drug Free Sport NZ and other agencies to professionally carry out the testing. I acknowledge by signing this form I maybe subjected to a drug/alcohol test at any time. I agree to such testing. I further agree that my name can be published by MNZ as having taken part in a drug/alcohol test together with the results of that testing.
13. I confirm that my machine complies with any technical rule(s) set out in the Manual of Motorcycle Sport and/or the Supplementary Regulations and that, to the best of my knowledge and belief, it is in safe working order and fit for competition.
14. Southland Motorcycle Club is not liable for any failure to hold or complete the event on the scheduled date if the organiser is prevented from doing so due to any force majeure event. In such case no refund of any entry fees or other competitor payments will be made and the organisers shall not be required to re-schedule the event. The organisers reserve the right to alter the meeting format as deemed necessary.
IF COMPETITOR UNDER 16 YEARS OF AGE ON RACE DAY
Parent/Legal Guardian Name
to see the terms and conditions (Supplementary Regulations)
I have read and accepted Disclaimer above & Terms and Conditions and I enter at my own risk
I confirm information I have supplied is correct
Cheques payable to – Oreti Super-X Track and post to:
38 Davisons Road, 2RD
Direct Credit – Oreti Super-X Track
02 - 0924- 0089527 - 000
(Please include class & name as ref)
Please make sure that you have filled out all
If your entry has successfully been submitted this page will change to a response page advising payment details
(Allow approx 20 seconds for page to submit)
PH:(03) 686 4901 | 027 4576430
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