2022 Circuit Racing Season Entry

Competitor (Vehicle Owner)

The Competitor is the owner of the vehicle per the log book. Both the vehicle owner and driver may be the same person.

Competitor - Given Name *

Competitor - Surname *

Email (Primary) *

Competitor - Phone No. *

Competitor - Address *

Competitor - NAMSC Member No. *

Competitor - Motorsport Australia Licence No. *

Driver (Circuit)

Driver - Given Name *

Driver - Surname *

Driver - Email Address *

Driver - Phone No. *

Driver - Address *

Driver - NAMSC Member No. *

Driver - Motorsport Australia Licence No. *

Driver - Emergency Contact Name & No. *

Vehicle (Circuit)

Vehicle - Make & Model *

Vehicle - Engine Capacity (cc) *

Vehicle - Colour *

Vehicle - Race No. *

Vehicle - Dorian Timer No. *

Vehicle - Log Book No. *

Event Fee(s) *

2022 Circuit Racing Season Entry - $ 800.00

Credit Card Information

Card Type

Card Number

Security Code

Expiration Date

Billing Name and Address

Billing First Name

Billing Middle Name

Billing Last Name

Street Address

City

Country

State/Province

Postal Code

Never Miss a Race.