National Round 4 – Entry - Karting South Africa

Driver Information

First Name *

Last Name *

Date Of Birth *

Racing Number *

MSA License Number *

Please upload a copy of your MSA License

No file chosen

Class *

Chassis *

Club *

Do you have your own transponder? *

Transponder Number *

Team / Who To Pit With

Contact Information

For competitors under the age of 18 this must be a parent, guardian or entrant who will be present at the event.

First Name *

Last Name *

Contact Number *

Email Address *

Physical Address *

Tyres

Tyres - Mojo C2

Tyres - Mojo D5

Entry Fee Summary

Entry Fee

- including control fuel

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo D5 - 1 Set

Mojo D5 - 2 Sets

Transponder Rental

Total

Declaration/undertaking by submitting this entry form:

I hereby undertake to adhere to all the relevant MSA rules, which will include the Sporting and technical rules amongst others.
I have read and understood GCR22 and acknowledge that by submitting this entry form, I am bound to adhere to this and all other GCRs
I, being the lawful parent/guardian of the above mentioned competitor, do hereby grant permission for him/her to drive in the above-mentioned event.
I hereby give permission for the organising club/promotors to use photographs, name and results of the competitor on social media and any other publishing.

KART.CO.ZA respect your right to privacy and therefore aim to ensure that we comply with the legal requirement of the POPI Act which regulates the manner in which we collect, process, store, share and destroy any personal information which you have provided to us.

I agree

Please do not fill in this field.

Driver Information

First Name *

Last Name *

Date Of Birth *

Racing Number *

MSA License Number *

Please upload a copy of your MSA License

No file chosen

Class *

Chassis *

Club *

Do you have your own transponder? *

Transponder Number *

Team / Who To Pit With

Contact Information

For competitors under the age of 18 this must be a parent, guardian or entrant who will be present at the event.

First Name *

Last Name *

Contact Number *

Email Address *

Physical Address *

Tyres

Tyres - Mojo C2

Tyres - Mojo D5

Entry Fee Summary

Entry Fee

- including control fuel

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo D5 - 1 Set

Mojo D5 - 2 Sets

Transponder Rental

Total

Declaration/undertaking by submitting this entry form:

I hereby undertake to adhere to all the relevant MSA rules, which will include the Sporting and technical rules amongst others.
I have read and understood GCR22 and acknowledge that by submitting this entry form, I am bound to adhere to this and all other GCRs
I, being the lawful parent/guardian of the above mentioned competitor, do hereby grant permission for him/her to drive in the above-mentioned event.
I hereby give permission for the organising club/promotors to use photographs, name and results of the competitor on social media and any other publishing.

I agree

Please do not fill in this field. Please do not fill in this field.

National Round 4 – Entry FORM

Driver Information

Contact Information

Tyres

Entry Fee Summary

Entry Fee

Entry Fee

- including control fuel

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo D5 - 1 Set

Mojo D5 - 2 Sets

Transponder Rental

Total

Driver Information

Contact Information

Tyres

Entry Fee Summary

Entry Fee

Entry Fee

- including control fuel

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo C2 - 1 Set

Mojo C2 - 2 Sets

Mojo D5 - 1 Set

Mojo D5 - 2 Sets

Transponder Rental

Total