Number of

Class:

First name:

Last name:

Date of birth:

Pits Area

Pits Area:

Registration Contact

Please enter your contact details.

Email address:

Address:

Event Day Contact

We use this information to ensure all riders have returned safely.

Mobile Phone Number:

Vehicle Registration:

Emergency Contact

Please provide the name and phone number of someone who can be contacted in the event of an emergency.

Name:

Phone number:

Disclaimer

Tick this box to acknowledge you agree with the disclaimer.

One last question:

Thank you.

The cost for your registration is $.

Please select your preferred payment method and click the Payment button to proceeed.

Payment Method			Fees		Total cost

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TikQR Demo Event