Kapi-Mana Motorcycle Club Pre-Sign on Form

Kapi-Mana Motorcycle Club Pre-Sign on Form
Rider Registration Information
Please select the event you wish to sign up for
Rider Details

First NameSurname
Please note, you must be a current club member to collect points at the KMMC Club Champs. Click here to renew or apply for a new membership
Bike Details

Race Number (i.e. 17)Make Model (i.e. YZ250F)
Class
Do you intend to double class at this event?
Second Class
Do you hold a current MNZ License?
If you require a day license, please see the team at sign on.
Race Day Fees - Please select all that apply
prevnext( X )
Main Track Events
$40.00 NZD



Mini Track Events
$30.00 NZD



Double Classing
$20.00 NZD



MNZ Day License
Only select if you do not hold a current MNZ license.

$50.00 NZD



Total

$0.00 NZD
Payment
Personal Contact Details
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Emergency Contact Details
Name of Emergency Contact

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
Agreement
I agree to compete entirely at my own risk, and indemnify the Kapi-Mana Motorcycle Club, all their officials and the landowner/occupier against all claims which may arise from this meeting.
Should be Empty:

Rider Registration Information