Gender *
MaleFemale
Age on Race Day *

First Name *

Last Name *

Email Address *

Cellphone Number *

RSA ID Number *

Mechanics Name *

Mechanics RSA ID Number *

Mechanics Cellphone Number *

Name of Emergency Contact *

Emergency Contact Number *

Medical Cover
YesNo
MSA License Number

Type of License
ClubRegionalNational

SpeedSpot MX Member *
YesNo
SpeedSpot MX Z Number
eg: Z8888

Racing Number *

Sponsors

Team Name

If you enter more than one class, for your second entry use the Members / non members 2nd class entry drop down where the cost of entry is already discounted in the form.

Note:
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 1st Class Entry
NoneMX 50cc Support (R450)MX 50cc (R550)MX 65cc (R550)MX 85cc (R550)MX Pro (R650)MX High School (R650)MX Support (R550)MX Quad (R500)Funduro (R350)

Non-Members 1st Class Entry
NoneMX 50cc Support (R500)MX 50cc (R650)MX 65cc (R650)MX 85cc (R650)MX Pro (R750)MX High School (R750)MX Support (R650)MX Quad (R550)Funduro (R450)

Members 2nd Class Entry
NoneMX 50cc Support (R450)MX 50cc (R450)MX 65cc (R450)MX 85cc (R450)MX Pro (R450)MX High School (R450)MX Support (R450)MX Quad (R450)Funduro (R450)

Non-Members 2nd Class Entry
NoneMX 50cc Support (R500)MX 50cc (R500)MX 65cc (R500)MX 85cc (R500)MX Pro (R500)MX High School (R500)MX Support (R500)MX Quad (R500)Funduro (R500)

TOTAL TO PAY: Calculate the total amount you owe *

If any question or comments, please type here

Download Self-Scrutineering Form

I hereby declare that I will ride with all the above compulsory equipment as presented.
Side Stands Not Permitted!

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. *
Yes

I have read and understand GCR’s 93,94,99,121 and 122 of the MSA General Competition Rules 2019 and signify my/our agreement to abide by these
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.

Declaration/Undertaking by the competitor *
If 18 years old or by the parent/guardian
Yes

Zone 7 Speedspot MSA
Capitec Bank
Branch Code: 47 00 10
Acc #: 1368246638
Reference: Name and Surname

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