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2021 NSW JUNIOR DIRT TRACK CHAMPIONSHIPS

POSTPONED NEW DATE TO COME

  Entry Form 

SATURDAY 14th  and SUNDAY 15th August 2021

at

Barleigh Ranch - 7 Barleigh Ranch Way Eagleton NSW

Please read Sup Regs  before filling out this form.  Click here to read

Entry Fees.

Juniors $80 extra classes $20 same bike, 2nd bike $40.00

Demo Class $40

 

Entries close  6th August 2021   

Bank Details.

 Account Name: Hunter Motorcycle Club

BSB:  650 000 Account No: 964702701 

NSW 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*

Next of Kin

Next of kin contact no

Entrant Name and MA Lic No

1st Class to enter

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Bike Details 1st Class make and cc

2nd Class

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Bike Details 2nd class Make and CC

3rd Class to enter

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Bike Details 3rd class Make and CC

Payment details for Hunter MCC

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Entry Fees:

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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.

Contact Information

Lyndel 0411 194 315

or

Keith 0412 516 339

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