Email form page for section 'mg-classic-entry'

Driver First Name *

Driver Last Name *

Street Address *

Suburb

City *

Telephone *

Email Address *

Age Group *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone *

First Time Driver? *

Yes, 3 or fewer race events completed
No, 4 or more race events completed

New Competitor to Manfeild? *

Yes
No

Foreign Participant on Non-NZ Race Licence? *

Yes
No

Class Entered

Vehicle No. *

Vehicle Make *

Vehicle Model *

Vehicle Colour

Vehicle Year *

Capacity in cc *

Certificate of Description (schedule K or T&C where applicable)

Log Book No. *

Car Club *

Club Membership Expiry Date (dd/mm/yyyy) or Life Member *

Race Licence Number *

Licence Grade *

C1 - National Race
C2 – National Race
C International Race Grade C

Licence Expiry Date (dd/mm/yyyy) *

NZ Civil Drivers Licence is current *

Yes
No

Supplementary Regs - I understand and agree to abide by the event supplementary regulations *

Yes I agree

Indemnity & Consent - I agree to the MotorSport New Zealand indemnity and to abide by the terms and conditions as set out for this event *

Yes I agree

Vehicle Conformance – I declare that the vehicle complies with vehicle safety items as set out for this event *

Yes I agree

Entry Fee $375

Late Fee $40 (if after 20th October)

Optional Donation to charity (Cancer Society or Kara Hands Charitable Trust)

Extra weekend Entry Passes @ $15 (drivers receive 4 entry passes Free)

TOTAL

Click here for the Supplementary Regulations (PDF)

NOTE: The entry fee for Lady Drivers who compete in the Sybill Lupp Trophy race is free. South Island and MG drivers need to contact ron@mgcarclub.org.nz to find out what their discount is.

GTRNZ drivers are reminded to pay their entry fee to their series co-ordinator.

Which image is the Flower?

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Date of Meeting: 12th, 13th, 14th November 2021
Circuit: Manfeild Circuit, Feilding

Entry Form

Copyright © MG Car Club New Zealand

Date of Meeting: 12th, 13th, 14th November 2021 Circuit: Manfeild Circuit, Feilding

Entry Form

Copyright © MG Car Club New Zealand

Date of Meeting: 12th, 13th, 14th November 2021
Circuit: Manfeild Circuit, Feilding