MNZ Permit 13516
MXChampsRnd4_EntryForm

  Rider Details  Classes  
 
Last Name: *   MXChampsRnd4  $      X 
First Name: *   MX 1  $120
Email: *   MX 2  $120
Mobile #: *   125cc 2 Stroke  $120
Postal Address: * MX 3 (Support)  $70
Town / City: *
Age on Race day: *   Tick if you want to enter Under 21yrs (you must have entered the 125cc 2 stroke class).    
Date of Birth: *  
Racing #: *     
Bike Make/Model/CC: *
MNZ License #:
Sponsors:
Date: SUBTOTAL   $ 
(If rider is under 16 years of age) Late Entry Fee if you are entering after 8th March, 2012. $100
Parent/Legal Guardian: TOTAL PAYMENT  $ 
Relationship:


I have read and accepted Terms and Conditions and I enter at my own risk.  *

I confirm information I have supplied is correct.  *

Click here to read Supplementary Regulations and general race information. 

Validation:

Clicking Submit will take you to the next form for Payment Options and Instructions.

By using our new online entry form and paying by Direct Credit, once your entry and payment are received you will get a confirmation email of your acceptance.