17+18 February 2018

ONLINE BOOKING

* Indicates required field

Date off trackday/weekend *

Name *

First

Last

ID Number *

Telephone *

Phone Number *

FAX *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Medical Fund Detail *

Email *

Next of kin name *

Next of kin contact number *

Motorcyle(s) to be used (make and capacity) *

I want to ride in the following group : *

A ( 2minutes and less) B ( 2 minutes up to 2:15) C ( 2min 15 sec and above)

I want to book for : *

SUBMIT BUTTON AT THE BOTTOM

Please Note the following RULES, you may be excluded from the event with no refund if you do not adhere to the rules stipulated below. Booking is not confirmed until payment has been received. In case of rain, or natural disasters, NO monies will be refunded. Participants MUST supply their own protective clothing (leathers, only 1 Piece or 2 Piece allowed in A and B Groups), including helmets, gloves and rider boots. Special protective rider pants and separate leather jackets will only be allowed in C group (no shoes except rider boots) leather gloves. Pillion riders are allowed in the C group only and pillions must wear full protective clothing as per rider. Bikes of participants must be in proper working condition and will undergo a check by the organizers. If the bike is found not to be in a good working condition or the tyres are worn then the participant will be excluded and no money will be refunded. No overtaking allowed in turns in C group. Overtaking is allowed in turns in the B group but only on the outside of the entry of a turn, once the bike is in full lean angle at apex of turn or at the beginning of the exit point overtaking will not be allowed. Overtaking is allowed in the A group a two metre clearance passing distance must be adhered to in all groups. Pit lane speed is 15 kilometers per hour, pit lane direction is as per track direction, participants may not stop on track, no stunts are allowed, not on the track nor in the pit complex. No rider may ride on track or anywhere in the facility on any motorcycle without a helmet. No alcohol may be consumed by participants, participants may only ride in one group. Riders must indicate when exiting the track and riders must follow flag rules. Flag rules will be explained at riders briefing – all participants must be present at riders briefing between 8:00 and 9:00 am. If a riders motorcycle spills oil then such a rider will be fined R500,00 payable immediately to event organizers. On all track weekends the track opens on Saturdays at 09:00 and close at 17:00 and on Sundays the track opens on 09:00 and close at 13:00, and if necessary 3 or 4 groups will be implemented depending on number of entries received. Lock wired. Racing conduct rules is available from the club racing rules on the website www.motorideracademy.com
RELEASE WAIVER AND INDEMNIFICATION The undersigned participant does hereby execute this release, waiver and indemnification for himself and his/her/their heirs, successors, representatives and assignees and hereby agree(s) as follows: To release Moto Rider Academy, Donald Andre Neethling, it’s representatives, sponsors and or any other participating individual/instructor, Phakisa Freeway,Free State Tourism, it’s governing body, it’s members, employees, agents, representatives and those governmental agencies affiliated with this event from any and all liability, not limited to all bodily injuries and property damage arising out of participation in the course referred to above, it being specifically understood that the said event includes the operation and use by the undersigned participant and others on motorcycles. This indemnification shall include all attorney fees incurred in defending against any claim or judgement agreed that the undersigned shall have the opportunity to consent to any such settlement, provided, however, that such consent shall be reasonably withheld. The participant agrees to abide by the safety rules of the event and agrees not to undertake any action not included in the event. Furthermore all ambulance and medical assistance will be for the participants account, you participate in this event at your own risk.
I HEREBY AGREE TO ALL THE RULES, TERMS AND CONDITIONS OF THIS ENTRY FORM, I H EREBY DECLARE THAT I HAVE READ THE TERMS AND CONDITIONS AND UNDERTAKE TO ADHERE TO ALL RULES AND DECISIONS OF THE ORGANIZERS INCLUDING WHAT GROUP I SHOULD RIDE IN – IF RIDER IS A MINOR THE PARENT OR GAURDIAN MUST SIGN ON HIS/HER BEHALF.

BANKING DETAILS

Standard Bank
Moto Rider Academy
Branch code: 055535
Account number : 281782741

Email: info@motorideracademy.com
Tel: 057 355 6519
Fax : 057 3556516
Cell: 084 5075767 (Andre)

I ACCEPT THE RULES AND REGULATIONS. *

YES

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