NSW Jun Track Champs

2019 HONDA

2019 NSW Honda JUNIOR TRACK CHAMPIONSHIPS

Entry Form

SATURDAY 16th AND SUNDAY 17th November 2019

at

ALLEN PARK MVRG DEBENHAM ROAD NORTH SOMERSBY NSW

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

Entry Fees.

Juniors $110 extra classes $30 each.

Demo Class $60

ENTRY FEES INCLUDE TRANSPONDER HIRE.

Entries close 4th November 2019

Bank Details.

Account Name: Central Coast Junior Motorcycle Club

BSB: 082-620 Account No: 57623 1127

NSW Junior 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 make and cc

2nd Class

Bike Details Make and CC

3rd Class to enter

Bike Details make and cc

Your Transponder Number if you are using your own.

Payment details for CCJMCC

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.

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Thank you entry has been sent to Lyndel

race secretary

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