2016 SA Historic Road Racing Championships

hmcrrsa-2016-poster-200Sat 31st Dec 2016 & Sun 1st Jan 2017

Mc Namara Park Road Racing Circuit, Mount Gambier SA

An ENTRY is not finalised until all conditions and requirements as detailed in the SUPPLEMENTARY REGULATIONS and ENTRY FORM are met/completed. Please ensure you read this document.

After completing this online Entry Form the details will be scheduled for processing and emailed to you for your files.

 

2016 SA HISTORIC ROAD RACING CHAMPIONSHIPS - ENTRY FORM

SA HISTORIC ROAD RACING CHAMPIONSHIPS
SAT 31st DEC 2016 & SUN 1st JAN 2017
McNAMARA PARK ROAD RACING CIRCUIT, MOUNT GAMBIER S.A.
Entries close 25TH NOVEMBER 2015
  • RIDER

  • Entrant

    (this is the rider's MA licensed sponsor - not the rider's name)
  • PASSENGER

  • Rider's Signature will be required at Event Registration
  • Passenger's Signature will be required at Event Registration
  • Parent Guardian's Signature will be required at Event Registration
  • Machine Details

  • (This goes in the program so make your description clear)
  • (This goes in the program so make your description clear)
  • (This goes in the program so make your description clear)
  • (This goes in the program so make your description clear)
  • I ACKNOWLEDGE THAT THIS MEETING WILL BE HELD IN ACCORDANCE WITH THE CURRENT GENERAL COMPETITION RULES (GCRs), THESE SUPPLEMENTARY REGULATIONS (OF WHICH THIS ENTRY FORM FORMS PART OF) AND ANY FINAL INSTRUCTIONS. BY ENTERING THIS MEETING ALL PARTIES AGREE TO COMPLY WITH THESE RULES, REGULATIONS, BY-LAWS AND INSTRUCTIONS.
  • Entry Fees

  • Price: $ 200.00 Quantity:
  • Price: $ 25.00 Quantity:
  • Price: $ 10.00 Quantity:
  • Price: $ 70.00 Quantity:
  • Price: $ 130.00 Quantity:
  • $ 0.00
    An ENTRY is not finalised until all conditions and requirements as detailed in the SUPPLEMENTARY REGULATIONS and ENTRY FORM are met/completed. Please ensure you read this document.
    Payment by PayPal, EFT, Cheque or Postal Order only.
    Any fees for dishonoured cheques will be the responsibility of the entrant.

    PayPal and EFT/Bank transfer payments are preferred
    EFT Details are: HISTORIC MOTORCYCLE RACING REGISTER OF SA
    Bank details BSB 805-050 A/C NO 100041411 please put your name down as reference
    Cheques and Money Orders are to be made payable to the Historic Motor Cycle Racing Register of SA.