Entry Form
Mainland Challenge 2025
Racer Information
Please fill name and contact information
Drivers Name
*
Mr.
Mrs.
Miss.
Ms.
Prefix
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Postal / Zip Code
Email Address
*
example@example.com
Phone Number
-
Area Code
Phone Number
Competition Licence Number
*
ORANZ Licence Expiry Date
*
/
Day
/
Month
Year
Date
Club Driver Belongs Too
*
DOB (if driver under 18 years of age)
-
Day
-
Month
Year
Date
Transponder Details
*
If you don't have one and are hiring, put 123456
Do you need to hire a transponder? ($50)
Yes
Next of Kin Details
*
First Name
Last Name
Next of Kin Phone Number
*
-
Area Code
Phone Number
Are you attending prizegiving?
*
Yes
No
If you are attending, how many people.
Additional Details
(To be completed in all cases if the Owner of the vehicle is other than the driver)
Owners Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owners Phone Number
-
Area Code
Phone Number
Vehicle Details
CC Capacity
*
Car Number
*
Vehicle Sponsors and online details if available (Website/Facebook page ETC ETC)
Please detail racing history for commentators and promotional material
Please Upload a Picture of Your Car We Can Use
Browse Files
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of
Mainland Challenge 2025 Entry Fee
Select all that apply per entry. If you are entering more than one car you do a full form per car.
Entry Selections
*
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( X )
Short Course Saturday Only
$
300.00
NZD
Enduro Sunday Only
$
300.00
NZD
Early Bird Both Days
$
480.00
NZD
Kiw Trucks (Free)
Don't Pay anything for this entry.
$
0.01
NZD
Transponder Hire
If you checked to hire a transponder earlier in the form, you must tick this and pay with entry.
$
50.00
NZD
All payments are to be made to Canterbury Off Road Club
03 1593 0018939 00 please use your surname and car # for reference. You are not confirmed entered until you have paid, and we see it in our account.
Date Completed
-
Day
-
Month
Year
Date
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