CENTRAL COAST CUP

HONDA/ THE CONSTRUCTION TEAM

2019 CENTRAL COAST CUP

Entry Form

25th and 26th MAY 2019

ALLEN PARK

SOMERSBY NSW

Please read Sup Regs click here before filling out this form.

Entry Fees:

Senior

– Class: $95 1st class $30 each extra class

- + Central Coast Cup $30 which includes the Clock on the Wall

Junior

- $70 1st class - $25 each extra class.

- + Central Coast Cup $25 which includes the Clock on the Wall

ENTRIES CLOSE 16th 2019

Bank Details.

BSB 082 620 Account No 57623 1127 Central Coast Junior MCC

Please remember to put riders name and # as reference.

Central Coast Cup 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 and contact No

1st Class to enter

Bike Details make and cc

2nd Class

Bike Details Make and CC

3rd Class to enter

Bike Details make and cc

I am a

ABN if professional rider

Payment details for Central Coast Junior MCC

Entry Fees:

My entry fee is $

Sponsors Details

Confirm you have read the Sup Regs

Make sure after you have hit the send button you will receive a sent message on the next page Might have to move page up to read it

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Thank you entry has been sent to Lyndel

race secretary

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