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2017 NEW ZEALAND MINI MX CHAMPIONSHIP ONLINE ENTRY FORM
Saturday 4th & Sunday 5th November 2017 - Permit #16987
ENTRIES ARE NOW CLOSED FOR THIS EVENT
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
ENTRIES NOW ACCEPTED SUBJECT TO ORGANISERS DISCRESSION (Official close off was 5pm 13th October)
YOU MAY STILL LODGE AN ENTRY & YOU WILL BE CONTACTED IF NOT ACCEPTED,
FOR ENTRIES RECEIVED AFTER 7AM 16TH OCTOBER NO TEESHIRT WILL BE AVAILABLE AS ORDER WILL HAVE BEEN PLACED.
NO ENTRIES WILL BE ACCEPTED ON THE DAY
Please select your class from the drop down list
Ensure you read the Supplementary Regulations to ensure you are entering the correct class.
Indicates required field
Class entered (Select class)
SUPPORT Intro 1 - Trail 50cc 4-5yrs ( Air or liquid cooled, auto clutch)
SUPPORT Intro 2 - Trail 50cc 6-8yrs (Air or liquid cooled, auto clutch)
SUPPORT Intro 3 - MX 50cc 4-7yrs (Air or liquid cooled, auto clutch)
CHAMPIONSHIP 7-11yrs Small Trail (wheel size 14" front 12" rear, 2 stroke air cooled 53-82cc & 4 stroke air cooled 53-145cc)
CHAMPIONSHIP 7-11yrs Big Trail (wheel size 19" front 16" rear, 2 stroke air cooled 53cc-82cc, 4 stroke air cooled 53cc-145cc)
CHAMPIONSHIP 6-8yrs 50cc MX (air or liquid cooled, auto clutch max capacity 53cc)
CHAMPIONSHIP 7-8yrs 65cc MX (53-65cc liquid cooled, 2 stroke, gear box & manual clutch)
CHAMPIONSHIP 9-11yrs 65cc MX (53-65cc liquied cooled, 2 stroke, gear box & manual clutch)
Refer to Supplementary Regs for licencing requirements for Championship classes
Machine & Capacity
Date of birth
Age on race day
MNZ Licence # (Please include CH or CL or OE if purchasing One Event Licence for support class)
Ensure you read
section on Licencing
- All riders must hold a MNZ Championship Licence to compete in a Championship Class (15.3). Before competing in a Championship Class riders must have competed in at least six MNZ permitted club events. Proof of this shall be from entries in the riders log book and can include up to a maximum of 3 one event licences (the original copies of the licences must be supplied - no reproduction copies)
Special Event Upgrade Licence
- Riders wanting to compete in a Championship Class who currently hold a MNZ Club Licence (CL prefix), may apply for a special event licence upgrade, this licence must be applied for & paid with this entry form. You may only apply for one special event licence upgrade per licencing year. Proof of 6 previous MNZ events as per above.
- Riders may compete on a MNZ Club licence (CL prefix),
Championship Licence (CH prefix)
or purchase a One Event Licence for support classes only.
Select Tee Shirt Size (included in entry)
Kids Size 4
Kids Size 6
Kids Size 8
Kids Size 10
Kids Size 12
Kids Size 14
Adults Size XS
Adults Size S
Adults Size M
Adults Size L
Adults Size XL
Adults Size 2XL
Additional TShirts @ $25 each. Please write size & quantity, ......... (ie 1 x 4 & 1 x XL)
TShirt Size Options:
Kids - 4,6,8,10,12,14
Adults - XS, S, M, L, XL, 2XL
Include Tee shirt (ensure you select your size)
All classes $130.00
Special Event Licence Upgrade - $50.00
Own Transponder (provide pin number) Deduct $10
One Event Licence Required $30.00 (support classes only)
Additonal Tee Shirt - $25.00 per teeshirt
Own transponder pin #
LATE ENTRY FEE
$25.00 - COMPULSORY from 7.30pm 13th October
Intended Payment Method
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 the undersigned declare that the motorcycles that I have entered for this competition are in good condition and comply with all the rules as set down by the MNZ Manual of Motorcycle Sport. I take full responsbility in respect of the coditions as set down ad also understand that a spot check may take place on my motorcycle before, during or after the event for safety and other reasons.
2. I shall abide by any decision directed at me by the Steward of the Meeting and understand that any competitor making a flase declaration may be disqualified from the event.
3. 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
4. I am aware that the sport of Motorcycle Competition might a) cause me injury; serious or otherwise b) damage my property.
5. I wish to take part in the New Zealand Mini MX Championship despite the above risks.
6. 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.
7. 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.
8. I am physically fit and there is no health or other reason why I should not participate in the sport of Motorcycle Competition.
9. 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.
10. I agree that in this disclaimer “my property” includes any property owned by me or in my possession or under my control.
11. I agree that this disclaimer will be binding on my family, my heirs, my legal assigns and my administrators and executors.
12. I accept that stripping and re-assembly for Technical Checks are at my cost.
13. 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.
14. 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.
15. 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.
If rider is under 16 years of age on race day/s or requires a One Event Licence form to be completed by Parent/Legal Guardian
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
I confirm information I have supplied is correct
Cheques payable to – Christchurch Off-road Motorcycle Club, and post to
NZ Mini MX Championship
C/- Adele May
38 Davisons Road
Direct Credit – CORMCC
03 - 0802 - 0877736 - 02
(Please include name in Particulars, class in code & ' MINI' 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)
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
PH:(03) 686 4901 | 027 4576430
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