SPEEDSPOT CLUB CHAMPIONSHIP ROUND 1
26 January 2019
MSA Permit: MSA 15691
Info: Janet Buys (Race secretary)
Cellphone: 083 3850227
Fax number: 086 2733379
If a 2nd or 3rd family member is entered, choose the discounted fee or members / non members 2nd or 3rd family member entry class on the next form.
Enter Class and secondary Class if necessary
Members / non members 1st Class Entry
---MX PW50cc, Newbie (R400)MX 80cc PW (R400)MX 50CC PRO (R500)MX 65CC (R500)MX 85CC (R500)MX 125CC OVER 35 YEARS (R500)MX HIGH SCHOOL (R600)MX PRO MINI (R500)MX LADIES (R500)MX1 (R600)MX2 (R600)MX3 (R500)MX SUPPORT (R500)MX QUAD (R500)
Members / non members 2nd Class Entry
---MX PW50cc, Newbie (R350)MX 80cc PW (R350)MX 50CC PRO (R350)MX 65CC (R350)MX 85CC (R350)MX 125CC OVER 35 YEARS (R350)MX HIGH SCHOOL (R350)MX PRO MINI (R350)MX LADIES (R350)MX1 (R350)MX2 (R350)MX3 (R350)MX SUPPORT (R350)MX QUAD (R350)
Members / non members 2nd or 3rd family entry
Please use this field when you enter the second or third family entry only.
---MX PW50cc, Newbie(R400)MX 80cc PW (R400)MX 50CC PRO (R400)MX 65CC (R400)MX 85CC (R400)MX 125CC OVER 35 YEARS (R400)MX HIGH SCHOOL (R400)MX PRO MINI (R400)MX LADIES (R400)MX1 (R400)MX2 (R400)MX3 (R400)MX SUPPORT (R400)MX QUAD (R400)
NON SpeedSpot MX MEMBERS !! *
Add the amount related to the number of entry.
R0 for SpeedSpot members
Non Members Extra R50 for one entry
Non Members Extra R80 for two entries
Spokes front and Back *
Wheel Bearing - F/B *
Tyre/Rim - F/B *
Brakes & Lever - F/B *
Mud Guard - F/B *
Sprocket Cover *
No's on 3 Sides of Bike *
Noise Control *
Handlebar & Padding *
Kill Switch *
Control Levers *
Foot Rests *
Kick Starts *
Self-Closing Throttle *
Chest Protector *
MX Boots *
Gloves & Goggles *
TECHNICAL CONTROL AFTER ACCIDENT
If a motorcycle is involved in an accident, the Technical Steward must check the machine to ensure that no defect of a serious nature has occurred. However, it is the responsibility of the rider / mechanic to present the machine for the re-examination together with helmet & clothing.
I hereby accept the Declaration above. *
Declaration/Undertaking to be signed by every competitor – Section 3
Declaration/Undertaking by the competitor *
If 18 years old or by the parent/guardian
Please email relevant documents to firstname.lastname@example.org.
This form is for a single rider only! Please submit a separate form for each family member rider! You can enter 2 classes with one form.