Landspeed Race Entry

Please complete the entry form below for our Landspeed event on 21st March ’26 ……Note maximum of 45 participants

Driver Details

First Name *

Last Name *

Date of Birth *

Month *

Day *

Year *

Mobile *

Email Address *

Street Address

City

Do you hold a valid, full NZ drivers license? *YesNoYou will need to present your license to the officials on race day.

Emergency Contact

Name *

Mobile *

Make *

Model *

Year *

Capacity (cc) *

Is Your Bike/Car *Turbo ChargedSuperchargedNitroNaturally Aspirated

I have a *BikeCar

Do you agree to the terms of entry? *

Yes, I have read and agree to the Terms of Entry and Indemnity

Do you agree to the race rules for your car? *

Yes, I have read and agree to the Race Rules For My Car

Do you agree to the race rules for your bike? *

Yes, I have read and agree to the Race Rules For My Bike

Signature

Start signing your signature here

Total Due Today:

$450

Credit / Debit Card *

Please do not fill in this field.