Mini-Moto Entry Form

    ZONE 7 MINI-MOTO EVENT – NIGHT RACING

    19 March 2021

    Info: Vicki Laubscher (Race secretary)
    Cellphone: 084 296 6873
    Email: admin@zone7.co.za

    Johann Spies
    Email: johann@zone7.co.za

    Fax number: 086 2733379

    Racing: 18:00 -> 22:00


    PERSONAL DETAILS

    First Name *

    Last Name *

    ID Number *

    Email Address *

    Cellphone Number *

    Address

    Bike Number *

    Class *
    50cc65ccPit Bike85cc/Farm BikeScooter

    MEDICAL & EMERGENCY

    Medical Cover
    YesNo
    Name of Emergency Contact *

    Emergency Contact Number *


    Declaration

    I signify my/our agreement to abide by the rules by submitting this entry form. I, the lawful parent/guardian of the above-mentioned competitor, do hereby grant permission for him/her to ride in the above-mentioned event. If a competitor is a minor, this form must be submitted by the appropriate parent or guardian.

    Indemnity

    I Acknowledge that motorsport is dangerous. By entering Zone 7 Speedspot Cape Town and using the facilities, I acknowledge the inherit dangers associated with this sport and therefor indemnify the owners, organizers and staff.

    I also indemnify the owners, organizers and staff on behalf of all non-riders and minors in my care. Therefor I utilize the facility on my own risk.

    Indemnity Declaration *
    I am 18 years or older, if not, authorised by a parent/guardian


    EFT PAYMENTs

    Entry Fee: R 200.00

    Zone 7
    Capitec Bank
    Branch Code: 470010
    Acc #: 1362378311
    Reference: Name and Surname

    Please email relevant documents to info@zone7.co.za.

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