2025 SACC Moto National Series
Round 4 - Maseru, LS. 4 October 2025
Full Name
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First Name
Last Name
Date of Birth
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Day
Year
Date
Email Address
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Phone Number
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Address
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I have a valid 2025 MSA License
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YES
License Number
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Race Number
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Emergency Contact Name
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First Name
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Emergency Contact Phone Number
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Medical Aid Provider
Medical Aid membership number
I have been declared medically fit to compete
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Yes
No
Team/Sponsor Name
ex: 'Team thank You Jesus'
Motorcycle Manufacturer
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Please Select
Gas Gas
Honda
Husquvarna
Kawasaki
KTM
Sherco
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Motorcycle Model
ex: CRF 450 F
Race Category
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SENIOR
JUNIOR
SACC Classes
National Open
National OR3
National High School
National Seniors
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Provincial Open
Provincial OR3
National 85cc Snr
National 85cc Jnr
National 65cc
Social Senior
Social Junior
Self Scrutineering
Engine Number
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Frame Number
*
Motorcycle
*
Riding Kit
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Environmental Safety
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Additional Safety
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Agree to Terms and Conditions
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I agree that neither MSA, nor the promotor, organizer, any vehicle owners or possessors, guarantor and/or sponsor of any competition or the owner/s of the property on which a competition is held, nor any government, provincial or municipal body, and their respective officials, agents, servants or representatives shall be liable under any circumstances for any damage done by or to any vehicle entered by or ridden in or attended upon by me, or for any personal injury – fatal or otherwise – or loss of whatever kind sustained by myself or any person whatsoever, while riding in or attending upon such vehicle, or while being present at any competition, whether caused during any competition or any practice or while the said vehicle is on any road or area forming part of the track or route or any deviation there from or any approach thereto (the event venue), by whatever means such damage, injury or loss may be caused, and even though the same may have been contributed to or caused by the willful act, neglect or default of any official, agent, servant or representative of MSA, or any promotor, organizer, guarantor or sponsor of the competition, or the owner/s of the property on which the competition is held or any government, provincial or municipal body.
I hereby indemnify MSA, the promotor, organizer, guarantor and sponsor of the competition and the owner/s of any property on which the competition is held and any government, provincial or municipal body and their respective officials, agents, servants and representatives against any legal liability for any damage or injury so done or sustained as aforesaid by myself or any other such persons as aforesaid.
I further admit and declare that I am fully aware of and appreciate the ambit and extent of the risks, dangers and perils attendant upon being present at or participating in motor vehicle/motorcycle/quad racing/karting, rallying or any other form or motorsport competition or activity described herein. I hereby voluntarily assume and consent to such risk and the risk of damages arising there from or injury or loss being sustained by myself or any other person as a result thereof. I further agree that this assumption of and consent to risk shall operate against my dependents and/or heirs, executors and administrators.
Doping/Alcohol Control: I hereby voluntarily and irrevocably give my consent to allow a Doping Control/Alcohol Control Officer to examine me prior to, during or following a motor sporting event, meeting or competition. I further consent and agree to allow a sample of my blood and/or urine to be taken for laboratory analysis by the Doping Control/Alcohol Control Officer concerned to determine the presence of alcohol or prohibited drugs listed in the MSA Anti-Doping Code, in accordance with the procedure for testing as prescribed by WADA (World Anti-Doping Agency). Should the analysis of the samples taken reveal the presence of alcohol or drugs or should I refuse to allow samples of blood and/or urine to be taken, I consent to MSA taking disciplinary action against me as envisaged in the Motorsport South Africa Anti-Doping Code – as prescribed by WADA (World Anti-Doping Agency).
My Products
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Senior National Entry
SACC National classes
1,400.00
ZAR
Quantity
1
2
3
4
5
6
7
8
9
10
Junior National Entry
SACC National classes
900.00
ZAR
Quantity
1
2
3
4
5
6
7
8
9
10
Senior Provincial Entry
SACC Inter Provincial Classes
1,100.00
ZAR
Quantity
1
2
3
4
5
6
7
8
9
10
Social Entry
JNR and SNR Social
750.00
ZAR
Quantity
1
2
3
4
5
6
7
8
9
10
Submit
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