Race Nomination Form
Club Meet
Race Date
*
-
Day
-
Month
Year
Membership Category
*
Member
Member (Family)
Junior Member (16 & under)
Non-Member
Junior Non-Member (16 & under)
Prospective (First Time Race)
Driver Name
*
First Name
Last Name
Email
*
How many classes?
*
Please Select
1
2
3
Class 1
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Vintage
Transponder No. 1
7-digits
Class 2
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Vintage
Transponder No. 2
7-digits
Class 3
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Vintage
Transponder No. 3
7-digits
How many junior entries?
Please Select
0
1
2
3
Junior Driver 1 Name
Junior 1 Class
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Junior 1 Transponder
7-digits
Junior Driver 2 Name
Junior 2 Class
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Junior 2 Transponder
7-digits
Junior Driver 3 Name
Junior 3 Class
Please Select
Novice
2WD Stock
2WD Modified
4WD Stock
4WD Modified
Stadium Truck / Short Course
Junior 3 Transponder
7-digits
Message to us
Fee Rate 1
Fee Rate 2
TOTAL RACE FEES $
Payment
*
Credit or Debit Card (1.9% surcharge)
Pay at Track
Fee + Surcharge
Card Payment Amount ($)
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AUD
Race Fees
Credit Card
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