ON LINE BOOKING FORM

2009 N.S.W. ROAD RACE CHAMPIONSHIPS ORAN PARK. 25TH -26TH APRIL.

 Please enter your details in the area provided. We do not reveal, disclose, sell, distribute, rent,  license, share or pass on to any third parties your personal information without your consent.

I have read the Supplementary Regulations and will sign a acknowledgment and Indemnity Agreement Forms at Sign-On. When you have filled out this form just click on Submit and it will be emailed to the Race Secretary.

When a drop down button is in place please make your selection.

The Clerk is CRAIG JOHNSTON

The MA Steward is ROBERT JOHNSTON

 Riders Name
 Sidecar Passenger Name
Address

 Phone Number Work: Mob:
 Email Address
 Prefered Number (two digit) Registered?

MA License Number: Expiry Date:

Scar Passengers MA License Number: Expiry Date:

Entrant Name: MA Entrant No: Expiry Date:

CLUB which appears on your licence:

Bike Details- Make: Model: CC:


1a. SUPERBIKE a-b-c-b $360.00
1b.SUPERSTOCK 1000cc $360.00
2a. SUPERSPORT $360.00
2b. SUPERSTOCK 600 $360.00
2c. CLUB SPORT $360.00
3. BEARS $360.00
4a.125GP 250cc Mono $360.00
4b. 400cc A -B $360.00
4c. 400cc C -D $360.00
5a. RETRO UNLIMITED $360.00
5b. RETRO Mod UNLIMITED $360.00
6a.SIDECARS F1 $385.00
6B.SIDECARS UNLIMITED $385.00
Credit Card Fee
5% of total fees
Deposit details:
CIRCUIT BREAKERS
BSB 062 260
ACCOUNT NO. 10027241 Fax or email confirmation.
Cheque/Money order, send to
Race Secretary
30 Grandview Cl.
Clarence Town NSW 2321

Oran Park 25th-26th April.

 
Credit Card Details
 Name on
 Credit Card
Type:    Expires 

 

Comments

   

To minimise fraud, your IP address has been recorded.

© Copyright 1997-2007 James Spence Promotions Pty Ltd. (ABN 37 077 106 640) All rights reserved.