Terry Baker Motorsport Weekend Entry Form

Car Details

Car Make

Car Model

Car Colour

Car engine capacity

Motorsport Australia Logbook Number (if issued)

Car engine location/drive type

AWD

Engine over Drive Wheels

Engine away from Drive Wheels

Driver Details

Driver Name

Address

Town/Suburb

Postcode

Phone Number

Email Address

Motorsport Australia Licence Number

Motorsport Australia Licence Expiry

Car Club

Car Club Membership Number

Car Club Membership Expiry Date

Junior Competitor

Yes

Emergency Contact Name

Emergency Contact Phone Number

Please Upload an image or screenshot of your Motorsport Australia Licence

Please Upload an image/screenshot of your Car Club Membership

Upload a PDF or image of your signed Risk Warning, Disclaimer & Indemnity form