iRace

Select Category and Class

Category Entered * Select the category you are competing in

Touring Car Challenge (TCC)
Muscle Division (MD)
Production Racing Cars (PRC)

Touring Car Challenge Class Entered Select the class you are competing in, within the category selected above

Muscle Division Class Entered Select the class you are competing in, within the category selected above

Production Racing Cars Class Entered Select the class you are competing in, within the category selected above

Competitor/Entrant Details

First Name * Enter the competitor's first name

Surname * Enter the competitor's surname

Preferred Race Number (1st choice) * Enter your first option for preferred race number

Preferred Race Number (2nd choice) * Enter your second option for preferred race number

Preferred Race Number (3rd choice) * Enter your third option for preferred race number

Competitor/Entrant Phone Number (BH) Business Hours contact number for the competitor/entrant

Competitor/Entrant Mobile Number Mobile contact number for the competitor/entrant

Competitor/Entrant Fax Number Fax number for the competitor/entrant

Competitor/Entrant Address Address for the competitor/entrant

Competitor/Entrant Email Address * Email address for the competitor/entrant

Sponsor (1) Your sponsor

Sponsor (2) Your sponsor

Driver Details

Driver First Name * Enter the driver's first name

Driver Surname * Enter the driver's surname

Driver Competition Licence Number * Enter the driver's licence numbers

Driver Competition Licence Type * Enter licence type: iRace, CAMS, AASA, etc

Driver Phone Number (BH) Business hours contact number for the driver (this may be a mobile number)

Driver Fax Number Fax number for the driver

Driver Date of Birth * Driver Date of Birth: DD-MM-YYYY

Driver Address * Enter the driver's address

Driver Email Address Enter the driver's email address

Driver Emergency Contact * Enter the name of the driver's emergency contact

Driver Emergency Contact Phone Number * Enter the contact number for the driver's emergency contact

Vehicle Details

Vehicle Make * Enter the competition vehicle make

Vehicle Year/Model * Enter the competition vehicle year and/or model

Vehicle Colour Enter the competition vehicle colour(s)

Vehicle Capacity * Enter the competition vehicle engine capacity in cc (Add a "T" if the car is turbocharged)

Vehicle Logbook Number * Enter the iRace Logbook Number for the competition vehicle

Vehicle Dorian Number * Enter the Dorian transmitter number (write "HIRE" if you need to hire a Dorian)

Supplementary Info

Garage Booking: I require the following * Enter your choice of garage

One Car Space (+$200)
No garage required (+$0)

TV Coverage Nomination Let us know if you would like to be featured in our coverage for this round or a future round, we will endeavour to fulfil requests, but cannot make any guarantees

No thanks
Yes
Yes, and I have an onboard camera that I am happy to share the footage
Yes, and I have data logging that I'm happy to share for onboard overlay
Other:

Acknowledgement * I acknowledge that I have read and agree with the driver's declaration/disclaimer, and that I agree to sign a printed copy of this entry at the event

Yes
No

Payment Type * Enter your intended method of payment. Entry fee is $395 plus any additional for the garage option you have selected

Credit Card (Mastercard or Visa)
PayPal
Cheque/Money Order

Referred By For first time iRace competitors, enter the name of the driver, team or person who referred you (if this is how you found out about iRace) and they will receive a small discount on their next entry

Independent Race Series

Round One Entry Form

Queensland Raceway - 31 March - 1 April 2012

Online

Mail Out

Hardcopy Form

Select Category and Class

Competitor/Entrant Details

Driver Details

Vehicle Details

Supplementary Info