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2021 NSW JUNIOR DIRT TRACK CHAMPIONSHIPS

POSTPONED NEW DATE TO COME

  Entry Form 

SATURDAY 14th  and SUNDAY 15th August 2021

at

Barleigh Ranch - 7 Barleigh Ranch Way Eagleton NSW

Please read Sup Regs  before filling out this form.  Click here to read

Entry Fees.

Juniors $80 extra classes $20 same bike, 2nd bike $40.00

Demo Class $40

 

Entries close  6th August 2021   

Bank Details.

 Account Name: Hunter Motorcycle Club

BSB:  650 000 Account No: 964702701 

NSW Junior Dirt Track ENTRY FORM if you are entering more then 3 class you need to fill in a 2nd form

First Name

Name*

MA Licence No

Licence Expiry Date

Address

City and Postcode

Birthday

Club

Mobile

Riding No

Email Address*

Next of Kin

Next of kin contact no

Entrant Name and MA Lic No

1st Class to enter

Bike Details 1st Class make and cc

2nd Class

Bike Details 2nd class Make and CC

3rd Class to enter

Bike Details 3rd class Make and CC

Payment details for Hunter MCC

Entry Fees:

My entry fee is $

Sponsors Details

Confirm you have read the Sup Regs *

After you have hit the send button, the next page will advise that your entry has been sent to me. YOU MAY HAVE TO MOVE THE PAGE DOWN A BIT TO SEE THIS.

Contact Information

Lyndel 0411 194 315

or

Keith 0412 516 339

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