Event Entry Form

Class entry:

Event entry plus 2 passes & 1 function ticket - $380*

Select which category your car is eligible for.

Extra entry details:

Dual Class entry
Transponder Hire
Late Entry Fee

Which second category do you wish to enter?

Extra Crew Passes

Price: $ 20.00 Quantity:

Hats

Price: $ 20.00 Quantity:

Extra dinner ticket

Price: $ 70.00 Quantity:

Extra dinner tickets will be limited so be in quick

Entry Total

$ 0.00

Driver details:

Emergency contact details

First Name*

Emergency contact name*

Last Name*

Phone number*

Your Email Address*

Relationship*

Date of Birth*

Entrant details:

(to be completed in all cases if Entrant is other than the driver. Licence must be purchased from MotorSport NZ Inc prior to the event in question and presented at documentation)

Car Club name*

Financial Member of the following MotorSport NZ Member Club?

Entrants Name*

Car Club expiry*

Attach a scan of your licence (max. 1MB file size)

Your residential address*

Postal Address

Leave empty if same as residential address.

Email Address

Telephone Number*

Competition License Number*

Entrants Licence Number

License Expiry*

Entrants Expiry Date

Licence Grade*

Currently is your NZ civil drivers licence disqualified?*

Yes
No

You must sign a declaration at Documentation as per NSC 43(2)(b)

Age group

Are you:*

You can select more than one option.

Vehicle details:

Make*

Transponder Number

Model*

Engine CC

Colour

Certificate of Description

Schedule K or T&C

Year of manufacture

* Actual year of completion of manufacture for this particular vehicle.

Logbook*

Attach a scan of your logbook (max. 1MB file size).

If possible, not required.

Car number

For Historic or Classic Vehicles - please select the following

Schedule K
Schedule T & C
Schedule CR

Schedule K Period Classification

Confirm the applicable period classification from the Schedule.

Schedule T & C Group

Confirm the applicable period classification from the Schedule.

Schedule CR period grouping

Confirm the applicable period classification from the Schedule.

Are you GST registered?

Yes
No

GST Registration No.

Name of Person / Company / Team Registered:

Car history... (if applicable)

*

I have read, and agree to abide by the Supplementary Regulations for this event.

Classic Motor Racing Club

Patron: Howden Ganley

SOUTH CANTERBURY HYDRAULICS SOUTHERN CLASSIC

Class entry:

Driver details:

Emergency contact details

Entrant details:

Vehicle details:

Contact us

About the Classic Motor Racing Club