Khanacross Online Entry Form

PLEASE NOTE:
Before completing this Entry Form, please see "Supplementary Regulations", "Disclaimer" AND 2 x Motorsport Australia Self-Scrutineering Forms, located under EVENT DOCUMENTS

* Only ONLINE Entries will be accepted.
* Only ONLINE Payment will be accepted.
* Only ONLINE (JPG, PNG or PDF files) Driver's Club Member AND Motorsport Australia Licenses will be accepted.
* Only CURRENT Licenses/Memberships will be accepted - Day Licenses/Memberships are not available.

= required

Email:

ROUND 5

Saturday, 21 November 2020

Motorsport Australia Permit #: 520/2111/03

VEHICLE DETAILS

Make & Model
Class
Log Book # (if applicable)
Car # (if applicable)

DRIVER DETAILS

First Name
Surname
Class
Address
Town/Suburb
State
Post Code
Email
Mobile #

EMERGENCY CONTACT DETAILS

First Name
Surname
Mobile #

LICENCE DETAILS

Club Member Licence Please upload a copy of your Club Member Licence. JPG, PNG and PDF files are accepted.
Motorsport Australia Licence Please upload a copy of your Motorsport Australia Licence. JPG, PNG and PDF files are accepted.

TERMS & CONDITIONS

Supplementary Regulations I have read, understood, acknowledge and agree to abide by the Supplementary Regulations at all times.
I agree
Motorsport Australia Self-Scrutineering I understand that I am required to print and complete the Motorsport Australia Self-Scrutineering Forms in order to participate in the Khanacross.
I understand
Risk Warning, Disclaimer and Indemnity I understand that I am required to print and complete the Risk Warning, Disclaimer and Indemnity Form in order to participate in the Khanacross.
I understand