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The re Scheduled event

2018 NSW Junior Track Championships

Entry Form 

Saturday 20th / Sunday 21st October

Lone Pine Speedway,

West Wyalong. NSW

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

Entry Fees.

Juniors $80 extra classes $25 each.

Demo Class $50

Entries close 10th October 2018

Riders who entered in June your entries will be transferred to this event unless advise by email to lyndelbutler93@gmail.com 

Bank Details.   

Account Name: Wyalong Motor Sport Club
Bank: NAB Taree BSB: 082 912 Account No: 515 024 941

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*

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

Payment details for Wyalong MSC

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

or

Nick 0434 015 662

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