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PRE EVENT INFORMATION
2019 MICHAEL GODFREY MEMORIAL ONLINE ENTRY FORM
Postponed to 28th & 29th September 2019
PERMIT #18309
Entries now open for all competitors up to 20th September & subject to space in class.
MX2 & MX3 entries have been re-opened. MX2 will have qualifying and non qualifiers will now have their own race not be put with MX3 entry numbers don't allow for this.
Some classes have very limited availability left, if class is full you will be notified and put on a waiting list.
Refer
Supplementary Regulations
for full event information.
Please submit a seperate entry for each competitor.
Please complete all fields and click on 'Submit' at the bottom of page to lodge your entry
CLASSES
NO ENTRIES WILL BE ACCEPTED ON THE DAY - ALL ENTRIES MUST BE PREPAID
Please select your class from the drop down list
Ensure you read the Supplementary Regulations to ensure you are entering the correct class.
Some classes will be split start so a maximum of 30 entries being accepted in total for these two classes - refer
supp regs.
MX3 is for Novice riders only (must be 17yrs & over) - experienced competitors will be moved to appropriate class at Race Directors discretion.
MX3 not eligible for Feature Races or to double class.
MX2 will have qualifying, those that don't qualify in the top 40 will be moved to a Non Qualifiers class.
If insufficient pre-paid entries are received by closing date - some classes may be combined or cancelled.
*
Indicates required field
SELECT YOUR CLASS
*
.
Mini Intro 4-7yrs (for first timers & beginner riders)
Mini 4-6yrs 50cc MX (Little 50cc)
Mini 6-8yrs 50cc MX (Big 50cc)
Mini 7-8yrs 65cc MX
Mini 9-11yrs 65cc MX
Mini Trail 7-11yrs (max 82cc 2 st air-cooled or 149cc 4 st air-cooled) *max 110cc for 7 year olds
Junior Pro 65cc 8-11 years (Mini or Jnr Licenced rider)
Junior 8-11yrs (60-85cc 2st + 100-150cc 4st)
Junior 12-16yrs (60-85cc 2 st + 100-150cc 4 st)
Junior 12-16yrs 125cc (90-125cc)
Junior 14-16yrs 250cc (151-250cc 4 stroke)
MX1 (Open cc) 17 years & over
MX2 (upto 125cc 2 stroke & 250cc 4 stroke) no 250cc 2 strokes
MX3 - (Open capacity Novice riders 17 yrs & over)
Senior 2 stroke (125cc & over 2 strokes only) 17 years & over
Ladies 15yrs & over (85cc 2 stroke - 250cc 4 stroke)
Enduro
Vets (35-44yrs)
Vets (45yrs+)
COMPETITOR DETAILS
Race Number
*
Name
*
First
Last
Machine & Capacity
*
Email
*
Phone
*
Date of birth
DD
*
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18
19
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25
26
27
28
29
30
31
MM
*
01
02
03
04
05
06
07
08
09
10
11
12
YYYY
*
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
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1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
Age on race day
*
2nd Class Race Number
*
2nd Class (Mini licenced riders & MX3 not permitted to double class)
*
.
12-16yrs (60-85cc 2 st + 100-150cc 4 st)
12-16yrs 125 (90-125cc 2 stroke only)
14-16yrs 250 (151-250cc 4 stroke only)
MX2 (upto 125cc 2 stroke & 250cc 4 stroke) no 250cc 2 strokes
MX1 (Open cc) 17 years & over
Senior 2 stroke (125cc & over 2 stroke only) 17 yrs & over
Ladies 15yrs & over (85cc 2 strokes - 250cc 4 strokes)
Enduro
Vets (35-44yrs)
Vets (45yrs+)
2nd Class Machine & Capacity
*
Address
*
Town/City
*
MNZ Licence # (or OE if purchasing One Event Licence)
*
Ensure you read
supplementary regulations
section on Licencing
.
If under 18 years then One Event Licences must be countersigned on the day by a Parent/Guardian.
FEES -
No family or 2nd class discount this year
Select applicable
*
One Event Licence Required $30.00
Entry Fee All Classes $130.00
Own Transponder (provide pin number) Deduct $10
Entry fees to be transferrred from original date
Own transponder pin #
*
LATE ENTRY FEE
*
$100.00 - COMPULSORY from 5pm 20th September
Intended Payment Method
*
Direct Credit
Cheque Being Sent
Total Payment $
*
DISCLAIMER OF LIABILITY: To Christchurch Off-road Motorcycle Club, and Motorcycling New Zealand Inc.
I have read and understood the Supplementary Regulations for this competition and agree to be bound by them and the Manual of Motorcycle Sport of Motorcycling New Zealand Inc. Together with the terms of the indemnification hereunder, and the requirements of the Noise Restrictions as listed. I indemnify Christchurch Off-road Motorcycle Club Motorcycling New Zealand Inc., Local Bodies and Landowner, their agents and all Officials against any claims arising from my attendance at this meeting.
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 Michael Godfrey Memorial MX 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 Christchurch Off-Road 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.
ONE EVENT LICENCE – I do not have a MNZ Competition Licence therefore require a One Event Licence for this event:
In the absence of holding a MNZ Competition Licence, I acknowledge that I am able to compete by partaking on a One Event Licence. By reading and acknowledging this disclaimer, the Supplementary Regulations and the following rules I acknowledge that I adhere to all conditions to compete at this event using the One Event Licence.
The ability to compete whilst using a one event licence may be withdrawn at any time by Motorcycling New Zealand.
I acknowledge that I will wear an approve helmet, along with approved boots, gloves, and motocross clothing as per the MNZ Manual of Motorcycle Sport – see www.mnz.co.nz
I acknowledge that no drugs or alcohol are permitted at this event, and I am not under the influence of either.
I acknowledge that I may be subject to random drug & alcohol testing as per the MNZ Manual of Motorcycle Sport.
I acknowledge that I have no medical condition that prevents me from safely participating in this event. I have not suffered concussion, or a head injury in the last three weeks.
My motorcycle is in a safe operating condition and type suited to the events that I am partaking in.
I acknowledge that attending riders briefing is compulsory
It is a condition of entry that all person having any connection with promotion, organisation, and conduct of the event including land owners, will be absolved from any liability out of any accident however caused and resulting in damage to property and or in respect of death or personal injury.
I fully indemnify Motorcycling New Zealand Inc., its agents representatives, employees, contractors, other competitors and promoters from and against any liability, whether or not due to any act or omission of these parties which arises from my participation in the event including by way of example any accident, damage or injury.
I agree that I have no medical condition that prevents me from safely participating in this event. I have not suffered concussion or had a head injury in the last three weeks. I acknowledge that should I suffer a head injury or concussion three weeks prior to this event that I will not partake due the MNZ stand down period.
If rider is under 16 years of age on race day/s or under 18 years & requires a One Event Licence form to be completed by Parent/Legal Guardian
CLICK
HERE
to see the terms and conditions (Supplementary Regulations) Any questions regarding this event, please refer to supplementary regs for
contact details of club officials.
Parent/Legal Guardian Name (who will be present on race day/s)
*
I have read and accepted Terms and Conditions above and I enter at my own risk
*
Yes
I confirm information I have supplied is correct
*
Yes
Competitor Sponsors
*
PAYMENT DETAILS
Cheques payable to – Christchurch Off-road Motorcycle Club, and post to
Michael Godfrey MX
Timing Tech
C/- Adele May
38 Davisons Road
NO2RD
TIMARU 7972
Direct Credit - NOTE NEW ACCOUNT NUMBER
CORMCC
06 0851 0450851 01
(Please include name in Particulars, class in code & ' MG' as reference
Please make sure that you have filled out all * required fields.
Your entry has been sucessfully submitted if this page converts to one thanking you for your entry.
(Allow approx 20 seconds to submit)
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