Choose event (required)
Twin Shock Challenge, Melrose (18th November)Round 8, Melrose (19th November)

Rider's full name (required, real name only please)

Parent or guardians name if rider is under 18yo

Are you riding with a minder who is not entered as a competitor?
NoYes

Email address (required)

Mobile number (required, in case of cancellation of event)

Machine make and capacity (required)

Grade (required)

Select entry type.

Personal Protective Equipment
The rider —Please choose an option—agreesdoes not agree to the following:
• Their helmet has an identification label
• Their helmet straps/buckles are in good condition
• Their helmet shell and lining are free from damage
• They will wear boots which cover the lower two thirds of their lower leg
• They will wear shirt and long pants
• Failure to comply with the above requirements will terminate their entry.

The declarant —Please choose an option—acknowledgesdoes not acknowledge the following
• They are familiar with the mechanical and electrical condition of the motorcycle
• They may be penalised if the information in this document is false
• Their equipment and machine may be inspected by event officials
• They will not attend the event if they are experiencing any cold or flu symptoms
• Failure to comply with the above requirements will terminate their entry.

Are you paying by direct deposit or cash on the day?
—Please choose an option—Direct depositPay on the day

I declare as the rider/declarant that the Information provided is true and correct.

Signature

Date

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