Mothar Mountain Speedway Gympie Forms

Gympie Speedway | Gympie Saloon Car Club | Mothar Mountain - Queensland's Premier Country Speedway | (07) 5482 4179

Gympie Saloon Car Club

- Old Noosa Rd, Gympie

Race Day Phone

07 5482 4179

phone

Gympie's Mothar Mountain Speedway - Gympie Saloon Car Club - 'The Home of Champions'

Mothar Mountain Speedway Forms

Download Forms from this page, print and fax return.

Mothar Mountain Speedway 2010-2011 Nomination Form

(print and fax in to 07 5481 2716)

Mothar Mountain Speedway 2010-2011 Membership Form

(print and fax in to 07 5481 2716)

Mothar Mountain Speedway Change of Details Form

(print and fax in to 07 5481 2716)

or, FILL OUT ONLINE FORM BELOW AND SUBMIT ONLINE

GYMPIE SALOON CAR CLUB LTD

P.O. B O X 2 5 8, G Y M P I E 4 5 7 0

ABN 77 009 882 991

Nomination Form 2010/2011

* required field
Nominating for Racing Category:*
Race Date :*
* required field
E-Mail:*
First Name:*
Last Name:*
Address:*
City:*
State:*
Post Code:*
Phone:*
Mobile:*
Member of:*
Make of Car :*
Racing Number :*
Sponsors:*
Q1.Do you declare your racing activities to be a hobby?:*	Yes No
Q2.Do you have an ABN?:*	Yes No
Q3.Are you registered for GST?:*	Yes No
* required field
I DO HEREBY AGREE to indemnify and to keep indemnified the Promoter, Landholder, their agents and officials from all actions, suits, claims and demands for damages or any other expenses whatsoever arising out of, or relating directly or indirectly to or from the use by me on the Gympie Saloon Car Club Ltd, Mothar Mountain Complex and its surrounds for the purpose of/or any purpose connected with practice and/or competitive racing and/or trails and/or motor events. I, further agree that I will promptly carry out any reasonable instructions from any Official of the Gympie Saloon Car Club Ltd and will not in any way, do or suffer to be done, anything contrary to the regulations of the said Club. The Driver shall be responsible for his Pit Crew according to the Racing Rules and Regulations of their Class/Division. All racing conducted under the ASCF Racing Rule Book. In Series events substitute cars may be used but such cars must have already been competing on the night. Refer to Rule No 13.15 (a),(b),(c),(d),(e) & (f). Any one driver can only accumulate points to his/her overall season point score from one car in each round of the heats and final per race night. All cars to be below 95 d.b.a. No glass containers are to be bought into the Speedway complex. It is against our Liquor Licence to bring alcohol into the speedway complex.*	Name: I Agree I Disagree Dated:
* required field
THE GYMPIE SALOON CAR CLUB RESERVES THE RIGHT TO ACCEPT OR REJECT ANY NOMINATION. NOMINATIONS CLOSE 12.30PM – ONE WEEK PRIOR RACING – NO EXCEPTIONS!
* required field
If under 18, Parent / Guardian Confirmation must be obtained:*	Parent/Guardian: I Agree I Disagree