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                     2019 SOUTHERN SERIES ONLINE ENTRY FORM
    ​    Permit Numbers  #18558 - SMCC,  #18565 - COMCC, #18619 - SOMCC, #18569 - GDMCC, #18672 - MDMCC

    Refer Supplementary Regulations  please read for full event information. 
    Please submit one form per competitor.
    Ensure you have completed all compulsory fields so that your entry submits.
    Read Disclaimer & click on submit at the bottom of the form.
    COMPETITOR DETAILS
    Note: Classes were finalised from entries received as at 16th August. 
    Due to insufficient entries the Ladies class has been cancelled, & the Vets 43-49 year class has been combined into Vets 35-49yrs.
    No day entries will be accepted - so very important you pre register  - (pay on day to the host club)
    Entries are accepted between rounds.
    ​Not sure which class to enter please read supplementary regs for full event and class information
    Date of birth
    All competitors must either hold a MNZ licence or purchase a one event licence - refer supp regs for further info.

    ENSURE YOU HAVE TICKED ALL THE ROUNDS YOU WISH TO ENTER

    YOU MUST BE PRE REGISTERED/ENTERED TO APPEAR ON THE ONLINE ENTRY LIST & SIGN IN SHEETS

    PAY EACH HOST CLUB ON THE DAY - NO PREPAYMENT REQUIRED
    Entry Fees:
    $20.00 per round - Mini Intro Class (for beginners only) - Not lapscored (One Event or MNZ licence required)
    $50.00 per round - Mini Lapscored Classes (all classes except above) - includes transponder hire
    $70.00 per round - Junior/Senior Classes  - includes transponder hire
    One Event Licence (required if you don't hold a MNZ licence) - $30.00 per round
    ​(You must also be a member of a MNZ affiliated club to purchase a One Event Licence)
    Discounts:
    Deduct $10  per round for a 2nd class (same competitor) - Mini's & MX3 not eligible to double class
    Deduct $10 per round for Family discount (1st family member full price, deduct for further members from same household)
    Family discount not applicable for Mini Intro class
    Deduct $5 per round if you own your own Mylaps Transponder (Barcode models not applicable must be MYLAPS)
    Refer supplementary regs for full event information

    LICENCE INFORMATION
    Refer to supplementary regulations for more detailed information
    All rounds are MNZ permitted events - as such each competitor must hold a current MNZ Licence or purchase a One Event Licence
    Save money & time  (at sign-in) by applying for a MNZ Licence before event
    * New/Welcome back licences available from $80 (12 months from date of issue)
    Go to http://www.mnz.co.nz/docs/default-source/licences/new or contact your local club or Timing Tech for further assistance

    If rider is under 16 years of age on race day or under 18 years & requires a One Event Licence
    Click here to read terms and conditions, & Supplementary Regulations.
    DISCLAIMER OF LIABILITY: To Southern Series Committee, Central Otago Motorcycle Club, Southland Motorcycle Club, South Otago Motorcycle Club, Gore & Districts Motorcycle Club,  Mosgiel & Districts 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 Southern Series 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 Southern Series Organising Committee 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.

    No confirmation email will be sent - please check instructions below
    to ensure entry successfully submitted.  Your name will appear on competitor list prior to event & closer to the event you will be emailed any further instructions/information relating to the event so please ensure you have put a valid email address.

    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)
    If you have missed a field "Please correct the highlighted fields" will appear below Submit Entry and the applic field will be outlined in Red