entry form template

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PRE EVENT INFORMATION

CLASSES

Refer Supplementary Regulations for available classes.

* Indicates required field

Class entered *

Note: Classes with * will have qualification into A & Support Class (refer Supp Regs for more info)

COMPETITOR DETAILS

Race Number *

Name *

First

Last

Machine & Capacity *

Email *

Phone *

Date of birth

DD *

MM *

YYYY *

Age on race day *

2nd Class Race Number *

2nd Class entered *

2nd Class Machine & Capacity *

Address *

Address line 2 *

Town/City *

MNZ Licence # *

FEES

Choose Any *

One Event Licence Required $25.00 per round Mini Intro (Not lapscored) $30.00 Mini (Transponders) $75.00 Junior/Senior (Transponders) $75.00 Own Transponder (provide pin number) Deduct $5

Late Entry *

Already included in Entry Fee

Intended Payment Method *

Total Payment $ *

Comments or Queries *

If rider is under 16 years of age on race day

Parent/Legal Guardian Name *

Click here to see the terms and conditions

I have read and accepted Terms and Conditions and I enter at my own risk *

Yes

I confirm information I have supplied is correct *

Yes

I wish to be added to Timing Tech Email List *

Yes No

I wish to be added to Timing Tech email database to receive email updates on event information and entry forms as released.

Click HERE to read Supplementary Regulations and general race information.

PAYMENT DETAILS

Cheques payable to – Christchurch Off-road Motorcycle Club, and post to

Winter Series MX
PO Box 120
AMBERLEY

Direct Credit – CORMCC 03 - 0802 - 0877736 - 00
(Please include class & name as ref)

Submit Entry

PH:(03) 686 4901 | 027 4576430
Email: noel.adele@xtra.co.nz

CLASSES

COMPETITOR DETAILS

FEES

If rider is under 16 years of age on race day

PAYMENT DETAILS

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