MEMBERSHIP APPLICATION

MEMBERSHIP FEES:

MEMBER 1:

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Phone:
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IMPORTANT: Please provide your email address so that we can alert you to any last-minute race day changes and provide other important notifications.
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NEXT OF KIN / EMERGENCY CONTACT DETAILS, NAME AND PHONE NUMBER:
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AMBULANCE COVER

It is recommended that you have an Ambulance Subscription which is separate to private health insurance as some health insurances do not cover ambulance for this sport.
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M.A Licence:

IMPORTANT:

1. If you do not hold a valid M.A. Licence Number and can't provide proof on the day you will need to purchase a Day Licence

2. This is for both Senior and Junior riders

3. This is Payable by Cash on the day of riding

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www.ma.org.au
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VIPER RACING NUMBER:

NOTE: Viper VMX race numbers of current financial members are reserved up to the end of the following year if those members have supported Viper VMX events in previous seasons. This cut-off allows a reasonable time for current members to renew their membership and a reasonable time for any number not retained to be reallocated before the new race season commences.
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List your top three Racing Numbers:

CLASSES:

All races for all classes will be 3 laps each race.

Please indicate below all classes you are entering.

Note: For anyone considering Pre 90 All Powers or Pre 97 All Powers, you are only eligible to race in either the novice or intermediate class, NOT in both classes.


The following recreation class will only be held at selected tracks:

Additional riders under 16 yrs

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