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PRE EVENT INFORMATION
New Zealand Supercross Championship
Round 2 (SX2 Class only)
Mt Smart Stadium, 2 Beasley Avenue Penrose, Auckland
Saturday 16th November 2019
MNZ Permit #18673
for event information.
Please complete all compulsory fields and then click on 'SUBMIT' at the bottom of the form.
Indicates required field
SX2 (126cc 2 stroke & 250cc 4 stroke)
Machine & Capacity
Date of birth
Age on race day
MNZ Licence #
Entry Fee - $250.00
Special One Event Licence upgrade - $50.00
Any questions regarding this event, please refer to
or contact Noel May: Phone 021 457643.
Intended Payment Method
Total Payment $
DISCLAIMER OF LIABILITY: To 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 New Zealand Championship Round 2 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 Motorcycling New Zealand 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. Motorcycling New Zealand 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 organisiers 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 (who will be present at the event)
Direct Credit only – MNZ
06 - 0329 - 0008518 - 00
(Please use 'SX AKL' as reference, Surname & MNZ Licence number as code)
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
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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