2025/26 ESSS Driver Registration Form

ESSS Driver Nomination Form

Proudly sponsored by JP Asphalting
Full Name

First NameLast Name
Birth Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
VSC#
Speedway Aus #
Club Member of
If other please specify
Car Number (Including prefix)
Helmet Tear off Part number?
We have a sponsor coming on board to sponsor 1x pack of tear offs to ALL heat race winners, having your code helps us to have the right tear offs available for you if/when you get that heat race win.
Do you have a transponder?
If YES please provide the number below.
Would you like to Pre-season Nominate?
If YES; Please select which tracks you would like to pre nominate for or to nominate for the all rounds please select "ALL".
Pre-Nominations are NOT required but are encouraged.

Your details will automatically be added to the nomination list of each round you have selected, this helps us plan and organise the rounds better for you, your crews, tracks and spectators, as we have a better understanding early on of our expected attending numbers.

IF at any stage you can no longer attend a round you have pre-nominated for please contact the ESSS prior to nominations closing.
Nominated Bank Details for prize money
Account name
BSB
Please provide details for your nominated Bank Account for prize money to be payable too.
Account #
Merch Pack Details

All drivers with completed registrations and fees paid recieve a series merch pack.
Shirt size
IF other please provide size
Hat or Beanie (Please pick 1)
AWARDS NIGHT

Bramleigh Estate Warryndyte

Date: June 26 2027

Includes:

3 course meal, Finger foods & soft drink

*Alcohol at bar prices

Driver tickets are included with driver nominations and are strictly allocated to nominated drivers only. Tickets are non-transferable due to sponsorship agreements

Additional tickets can be pre purchased now for $70.00, otherwise $80.00 later in the season.
Terms & Conditions

My Products

ESSS Nomination Fee

All nominated driver tickets are covered by nomination fee, as well as the "Drivers Merch Pack"

$130.00 AUD Quantity

Additional Awards night ticket

Pre-purchase awards nights tickets for family, friends and crew (these tickets will be $70.00 after the fact)

$70.00 AUD Quantity

ADDITIONAL MERCH?

Would you like to pre-purchase additional merch while you are here? These will be available for pick up from the first round of the 2025/26 season. *Please write in comments what sizing for hoodies and t-shirts

$30.00 AUD

	Quantity	Price
BEANIE		$30.00 AUD
TRUCK CAP		$25.00 AUD
SNAP BACK CAP		$25.00 AUD
BUCKET HAT		$25.00 AUD
FLEX FIT CAP		$35.00 AUD
HOODIE		$75.00 AUD
T-SHIRTS		$45.00 AUD
KIDS T-SHIRTS		$35.00 AUD

Item subtotal:

Total

Payment Methods

Credit Card

Apple Pay

Direct Bank Transfer

ACCOUNT NAME: Kayla Mannix

BSB: 062 692

ACCOUNT# 8137 3170
Should be Empty:

ESSS Driver Nomination Form

My Products

Payment Methods