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 TAREE MCC will conduct

2019 TAREE TWILIGHT

Entry Form

19TH JANUARY 2019

OLD BAR ROAD SIDE RACEWAY

OLD BAR- TAREE - NSW 

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

 Entry Fees:

Senior

– Class: $100. 1st class $20 each extra class

Sidecars - $120.00

Junior

- $80 1st class - $20 each extra class. 

Demo $40.00

ENTRIES CLOSE 11TH JANUARY 2019

IF YOU ARE HAVING A PROBLEM ENTERING PLEASE EMAIL YOUR INFORMATION lyndelbutler93@gmail.con

Bank Details.

BSB 082 856 Account No 1202 03128 TAREE MCC

Please remember to put riders name and # as reference. 

TAREE TWILIGHT 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

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

Contact Information

Lyndel 0411 194 315

Sam 0429913177 

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