ZONE 7 Fun Duro day
R 20,000 of Raffle Prizes to be Won (No cash prizes)
03 December 2022 (09:00 – 14:00)
Use this form to enter now, or at the track on the day.
Info: Romanda Marais (Fun Duro secretary) Email: mxadmin@zone7.co.za Cell: 073 036-4468
Chairman: Johann Spies Email: johann@zone7.co.za Cell: 073 182-9480
NB NOTE This form is for a single rider only! Please submit a separate form for each family member rider!
PERSONAL DETAILS
Gender * MaleFemale Age on Race Day * First Name * Last Name * Email Address * Cellphone Number * Date of Birth (dd-MMM-yyyy) *
MEDICAL & EMERGENCY Name of Emergency Contact * Emergency Contact Number *
CLASS SELECTION PLEASE READ CAREFULLY
Choose Your Ride —Please choose an option—Bike R350Quad R350Under 12 R300
TOTAL TO PAY: Calculate the total amount you owe *
If any question or comments, please type here
PLEASE READ CAREFULLY
I hereby declare that I will ride with all the above compulsory equipment as presented.
TECHNICAL CONTROL AFTER ACCIDENT If a motorcycle is involved in an accident, the Technical Steward must check the machine to ensure that no defect of a serious nature has occurred. However, it is the responsibility of the rider / mechanic to present the machine for the re-examination together with helmet & clothing.
I hereby accept the Declaration above. * Yes
Declaration/Undertaking to be signed by every competitor – Section 3
I have read and understand General Competition Rules 2019 and signify my/our agreement to abide by these rules by submitting this entry form. I, the lawful parent/guardian of the above-mentioned competitor, do hereby grant permission for him/her to ride in the above-mentioned event. If a competitor is a minor, this form must be submitted by the appropriate parent or guardian.
Declaration/Undertaking by the competitor * If 18 years old or by the parent/guardian Yes
EFT PAYMENT
Zone 7 First National Bank Current Account Acc #: 62317115493 Branch Code: 250655 Reference: Name and Surname
Please email relevant documents to info@zone7.co.za.
NB NOTE This form is for a single rider only! Please submit a separate form for each family member rider! Please leave this field empty.