Registration Form

Southern Scooter Challenge

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INDIVIDUAL Registration (1x Bike, 1x Rider)
Scroll down for Teams registration

* Indicates required field

Rider Name *

First

Last

Email *

Phone Number *

Registration Plate Number *

I would like a $25 T-Shirt (State below SIZE) Payment to be made in cash at registration check in. *

S M L XL XXL XXXL No Thanks

I would like morning tea ($10) each (payment to be made on the day at the venue) *

Yes No

How many for Morning Tea, Lunch and Prize giving? (You and Your Support Crew?) *

I have read & agreed to the Terms & Conditions *

YES

Submit

TEAM Registration

* Indicates required field

Team Name *

Team Leader/Rider Name *

First

Last

Number of Riders in Team *

Number of Scooters in Team *

Email *

Phone Number *

Registration Plate Number/s *

I would like a $25 T-Shirt (state SIZE below) Payment to be made in cash at Registration Check in. *

S M L XL XXL XXXL No Thanks

I would like Morning Tea ($10) each (to be paid on the day at the venue) *

Yes No

How many for Morning Tea, Lunch & Prize giving? (You, Your Team and Support crew?) *

I have read & agreed to the Terms & Conditions *

YES

Submit