Junior Fun Event:

    ZONE 7 50 CC FUN DAY

    28 September 2019

    Info: Janet Buys (Race secretary)
    Cellphone: 063 795-4346
    Email: info@zone7.co.za

    Chairman:
    Johann Spies
    Email: johann@zone7.co.za

    Fax number: 086 2733379


    NB NOTE
    This form is for a single rider only! Please submit a separate form for each family member rider!

    Fields marked with (*) are compulsory. These fields must be completed for the form to be submitted correctly and successfully.

    PERSONAL DETAILS

    Gender *
    MaleFemale
    Age on Race Day *

    First Name *

    Last Name *

    Email Address *

    Cellphone Number *

    Date of Birth (dd-MMM-yyyy) *

    MEDICAL & EMERGENCY
    Name of Emergency Contact *

    Emergency Contact Number *

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

    Racing Number *

    Sponsors

    Team Name

    CLASS SELECTION
    PLEASE READ CAREFULLY

    Members / non members


    TOTAL TO PAY: Calculate the total amount you owe *

    If any question or comments, please type here

    PLEASE READ CAREFULLY

    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. *

    Declaration/Undertaking to be signed by every competitor – Section 3

    I have read and understand 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


    EFT PAYMENT

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

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

    NB NOTE
    This form is for a single rider only! Please submit a separate form for each family member rider!

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