GXCC RIDER PROFILE 2024

RIDER PROFILE
Competitor Information

Please enter your details below
Bike Number*
This number must be issued by MSA each year. Go to our website to access the link to the race number request form.
Name & Surname*

NameSurname
ID Number*
International riders, please enter your passport number
Date of Birth*

DayMonthYear
Date
Nationality*
Region where you permanently reside*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Club Information

Please enter your club details below
Club Name*
Club Membership No*
Team & Sponsor Information

Please insert your team and/or sponsor information below.
Team Name
Sponsors
Motorsport South Africa (MSA) License Information

Please complete your MSA license information below. All GXCC events are sanctioned by MSA. We do not accept any other licenses.
License No*
If you will be taking out a one-event Social License and don't have a license yet, kindly insert "OE Social" in the space above.
Status*
PLEASE NOTE: To compete in the club (GXCC) championship, you need a CLUB license. To compete in the club (GXCC) and regional (Northern Regions) championship, you need a REGIONAL license. To compete in the Social Class, you need a one-event SOCIAL license.
Category*
PLEASE NOTE: To race GXCC, you need an annual or one-event Cross Country Bikes & Quads/Enduro license or a one-event Social License
Expiry Date*

DayMonthYear
If you will be racing in any of the Social Classes, please choose the date of the event as the expiry date of your license
Amount of Insurance held with MSA*
Please upload a copy of your MSA license*

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Please upload a copy of your medical aid card*

Cancelof
Medical Information

Please complete your medical information below
Medical Aid Name*
If you are not a member of a medical aid, please insert "None" in this space
Medical Aid Number
Please list any medical conditions that you may have
Please list any allergies that you may have
Emergency Contact Person Name & Surname*
Emergency Contact Person Phone Number*
Please enter a valid phone number.
Bike Details

Please complete your bike details below
Type*
Make*
Model*
Stroke*
Capacity*
Frame/VIN Number*
Engine Number*
Should be Empty:

RIDER PROFILE

Competitor Information

Club Information

Team & Sponsor Information

Motorsport South Africa (MSA) License Information

Medical Information

Bike Details