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 TAREE MCC will conduct

2019 TAREE TWILIGHT

Entry Form

19TH JANUARY 2019

OLD BAR ROAD SIDE RACEWAY

OLD BAR- TAREE - NSW 

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

 Entry Fees:

Senior

– Class: $100. 1st class $20 each extra class

Sidecars - $120.00

Junior

- $80 1st class - $20 each extra class. 

Demo $40.00

ENTRIES CLOSE 11TH JANUARY 2019

IF YOU ARE HAVING A PROBLEM ENTERING PLEASE EMAIL YOUR INFORMATION lyndelbutler93@gmail.con

Bank Details.

BSB 082 856 Account No 1202 03128 TAREE MCC

Please remember to put riders name and # as reference. 

TAREE TWILIGHT 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 and contact No

1st Class to enter

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Bike Details make and cc

2nd Class

Bike Details Make and CC

3rd Class to enter

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Bike Details make and cc

I am a

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ABN if professional rider

PAYMENT DETAILS

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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

Sam 0429913177 

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