Rider's name *

First

Last

Email *

Phone *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Date of birth *

Age *

Gender *

Guardian's name *

First

Last

if rider is under 18 years of age

Motorbike brand *

Motorbike year *

Do you have a valid MNZ affiliated club membership? *

Yes
No, sign me in with the Pioneer Motorcycle Club ($40)

Your club's name *

Do you hold a current MNZ licence? *

Yes
No, I need a One Event Licence ($35)

If you enter with a one event licence you won't be included in the results for the championship classes. You will only be included in the results for the support class that you ride in.

What is your MNZ licence type? *

Championship
Club
Junior
Mini

If you enter with a club licence you won't be included in the results for the championship classes. You will only be included in the results for the support class that you ride in.
See https://mnz.co.nz/licences/mnz-licences/ for more information about championship and club licences.

MNZ licence number *

Select your grade *

* A championship licence is required for the orange grade.

Select your class or classes *

Entry fees *

Senior ($125 if paid by 25 August)
Senior ($150 if paid after 25 August)
Junior ($50 if paid by 25 August)
Junior ($70 if paid after 25 August)
Mini ($20 if paid by 25 August))
Mini ($30 if paid after 25 August)

Do you have a minder?

Minder's name *

First

Last

Does your minder have a current MNZ affiliated club membership? *

Yes
No, sign him/her in with the Pioneer Motorcycle Club ($40)

Your minder's club name *

Does your minder hold a current MNZ licence? *

Yes
No, he/she needs a One Event Licence ($35)

Minder's MNZ licence number *

Entry fees for Minders *

$50 (if paid before 25 August)
$70 (if paid after 25 August)

Total Amount

$0.00

including booking fees

Disclaimer of liability *

I have read and agree to the Terms of Entry listed below

1. I confirm that my machine complies with any technical rule(s) set out in the Manual of Motorcycle Sport (Off road) and/or the Supplementary Regulations and that, to the best of my knowledge and belief, it is in safe working order and fit for competition.
2. I take full responsibility in respect of the conditions as set down and also understand that a spot check may take place on my motorcycle before, during or after the event for safety and other reasons.
3. I shall abide by any decision directed at me by the Steward of the Meeting. And understand that any competitor making a false declaration may be disqualified from the event.
4. I have read the Supplementary Regulations for this Competition and agree to be bound by them and the Manual of Motorcycle Sport, the MNZ Constitution, and the MNZ Code of Conduct.
5. I am aware that the sport of Motorcycle Competition might (a) cause me injury; serious or otherwise (b) damage my property.
6. I wish to take part in the 2024 South Island Moto Trials Championships despite the above risks.
7. Neither I, or anyone associated or connected with me will make any claim against you or your officers, employees or agents in respect of: (a) any injury suffered by me; or (b) any damage to any of my property regardless of how the injury or damage occurs.
8. I will indemnify you against all claims, damages or losses (including costs) which you incur as the direct or indirect result of any injury to me or damage to my property.
9. I am physically fit and there is no health or other reason why I should not participate in the sport of Motorcycle Competition.
10. I am aware that this disclaimer will not affect any legal obligations you have to me which you cannot contract out of under NZ Law.
11. I agree that in this disclaimer “my property” includes any property owned by me or in my possession or under my control.
12. I agree that this disclaimer will be binding on my family, my heirs, my legal assigns and my administrators and executors.
13. I accept that stripping and re-assembly for Technical Checks are at my cost.
14. I consent to the details contained in this form being held by the Hosting / Administering Motorcycle Club for the purpose of the promotion and the benefit of the race meeting concerned, and Motorcycling in general. I acknowledge my right to access and correction of this information. The consent is given in accordance with the Privacy Act 2020.
15. MNZ supports the FIM/IOC Charter on drugs in Sport. MNZ uses the services of Drug Free Sport NZ and other agencies to professionally carry out the testing. I acknowledge by signing this form I may be subjected to a drug/alcohol test at any time. I agree to such testing. I further agree that my name can be published by MNZ as having taken part in a drug/alcohol test together with the results of that testing.

Debit / Credit Card *

Card

Name on Card

Day	1	2
Address	Manderley Station 3875 Christchurch-Akaroa Rd -43.789579, 172.758498	Graylees Rd. 2217 Christhuch-Akaroa Rd, Ataahua -43.757546, 172.626320
Sign on time	8.30am	8.30am
Riders briefing	9.30am	9.30am
Event starting time	10am	10am

South Island Championship rounds 1 & 2

September 7 @ 10:00 am - September 8 @ 3:00 pm

Details

Organiser

Venue