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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

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Bike Details make and cc

2nd Class

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Bike Details Make and CC

3rd Class to enter

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Bike Details make and cc

Your Transponder Number

Payment details for Wyalong MSC

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Entry Fees:

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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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