Race Nomination Form

Race Date *

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? *

Class 1

Transponder No. 1

7-digits

Class 2

Transponder No. 2

7-digits

Class 3

Transponder No. 3

7-digits

How many junior entries?

Junior Driver 1 Name

Junior 1 Class

Junior 1 Transponder

7-digits

Junior Driver 2 Name

Junior 2 Class

Junior 2 Transponder

7-digits

Junior Driver 3 Name

Junior 3 Class

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 ($)

AUD Race Fees