Ruapuna Test Day Registration Form

Please fill in your details below to register for this car run in day.

Pre entry is highly recommended.

If you register, but then can not make it, please let us know.

Dual driver cars, please submit one form per driver and let us know

Preferred payment methods:
- Pre pay to CCC bank acc 02 0865 0020166 25
- Contactless card payment
- Pay on the day, EFTPOS or cash

If making bank transfers please ensure this is done early enough to show in our acc and use a useful reference.

Date registering for: *

Tue 30 Aug Car Run-In day

To register for other dates see https://www.canterburycarclub.co.nz/track/test-days/
One form per test day / car run in day

Driver/Rider Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City

Email *

Phone Number *

Date of Birth *

Next of Kin (In case of Emergency) *

Name Phone Number

Dual Drive, Sharing Car With:

2nd driver name. Form for each driver required

Vehicle Type *

Saloon Car Single Seaters / Open Wheelers

Car Make and Model *

Colour *

Race Number

Member Club *

Canterbury Car Club Other

Cost
Car run in mornings:
$30 CCC Members
$50 Other MSNZ Clubs

Bank a/c for online payments:
Canterbury Car Club 02 0865 0020166 25
Please use Test Day and your name as a reference

After a driver/rider arrives at the track and signing in on the day, the supplied wristband must be worn to gain track access.

Driver/Rider must present a vehicle which meets current regulations for car or motorcycle racing in New Zealand

Appropriate safety gear (helmet & overalls/leathers must be worn at all times on track, see T&C for full details

Instructions of staff & volunteers must be followed at all times.

*

By submitting this form and signing it on arrival it at the track; I agree to the rules, terms and conditions given verbally by staff or on https://www.canterburycarclub.co.nz/track/test-days/ and that the information submitted on the form is accurate and correct

Ruapuna Car Run-In Day Registration