Bikes test & Tune Friday 25th January 20192019 Bikes Test & Tune - Friday 25th January Rider DetailsFirst Name*Last Name*Mobile No.*Email* Address* Street Address Address Line 2 City State Post Code Emergency Contact Name*Emergency Contact Number*Do you need a Motorcycling Australia day license?*YesNoPlease enter your Motorcycling Australia License No.Motorcycling Australia License No.*License Expiry* MA Day Licenses available for $50 from the track, on the day of event.Motorcycle DetailsPlease select your Motorcycle type*Please select your Motorcycle typeRoad BikeRace BikeJunior Race BikeYear of Motorcycle*Please Select201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Make*Model*Colour*Preferred Race Number*Capacity*Additional HireGarage HireYes, Id like to hire a SINGLE "T" GARAGEYes, Id like to hire a DOUBLE CARPORT (3 motorbikes only)NonePayment / Terms & Conditions"I/We have read and understood the Supplementary Regulations issued for this Meeting and agree to be bound by them and by the National Competition Rules of Motorcycling Victoria. I/We also acknowledge and agree that neither Motorcycling Victoria, nor Winton Motor Raceway Pty. Ltd., nor the sponsor organisations, nor the land owners or lessees, nor the organisers of the race meeting/ event, nor their respective servants, officials, representatives or agents (all of whom shall collectively be called "the Organisers"), shall be under any liability for my death, or any bodily injury, loss or damage which may be sustained or incurred by me, as a result of participation in or being present at the event, except in regard to any rights I may have arising under the Trade Practices Act 1974. I/We acknowledge that motor sport is dangerous and accidents causing death, bodily injury, disability and property damage can, and do, happen. I/We accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by Motorcycling Victoria and the Associated Entities.Acceptance of Terms & Conditions* I accept I/We have read the above terms and conditions.Entry Fee Bike T & T Nov 22nd* Price: $ 175.00 T Garage - Powered Garage Hire Bike T & T Nov 22nd* Price: $ 50.00 Double Carport Hire - Bike T & T Nov 22nd* Price: $ 30.00 Booking Fee Bike T & T Nov 22nd* Price: $ 0.00 Total $ 0.00 Credit Card*MasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Security Code Cardholder Name This iframe contains the logic required to handle Ajax powered Gravity Forms.