- Aust Jun Dirt Track TAREE

Husqvarna Motorcycles

2017 Australian Junior Dirt Track Championships

Entry Form

Saturday 23rd / Sunday 24th September 2017

OLD BAR TAREE NSW

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

Entry Fees.

Juniors $135 extra classes $30 each.

Demo Class $60

Entries close 8th September

Bank Details.

Account Name: Taree Motorcycle Club

Bank: NAB Taree BSB: 082 856 Account No: 1202 03128

Aust 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
Entrant Name and MA Lic No
Number of People accompanying me
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
My T Shirt Size is
Payment details for Taree 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
Send Message

Thank you entry has been sent to Lyndel

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race secretary