L6 Registration Leave a Comment / By cemaracing.com / 27 July 2024 ID Number *If No ID, use YYMMDD Format, for example- 020508 (08 May 2002)Full name and Surname *Age *License Number (NMSF) #503 *Enter License NMSF#503Tel. Work *Tel. Cell *Email Address *This field is required. Please enter email.Nominated Club *Please select an optionWalvisbay Motor ClubSwakop KartersWindhoek Motor ClubKart Number *Full name and Surname *License # (NMSF) (#TBC) *Email Address *This field is required. Please enter email.Street Address *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweTel. Work *0 / 10Tel. Cell. *0 / 10Chassis Brand *Please select an optionTony KartSodiBirelARTCRGEnergy KartExpritFormula KGold KartHaaseIntrepidKosmicMac MinerelliParolinPragaRicciardo KartRS KartTop KartChoose Chassis BrandClass *Please select an optionBambinoKid RokMini RokMaxterinoMicro MaxMini MaxJunior MaxDD2DD2 MastersSenior MaxSelectMain Sponsor *Other Sponsors *In Case there are no Other Sponsors, Add NACalculationsTotal Entry CostTransponder Needed *Transponder NeededYes - N$400No - N$0.00Transponder NumberIf you have a Transponder, please add the number. If you do not have one, please add 0Conditions to Declare *Medication to declare *Medical Aid Number *Medical Aid Scheme *Preferred Hospital in case of Emergency *NOTE NOTE: Please be informed if no medical aid details provided, you will be transported to the nearest State Hospital in times when an accident happened and you need to be Hospitalised!! Drug testing in sport is always possible, especially in cases of accidents or accidental death of co-drivers and /or spectators. It is the responsibility of the competitors to ensure that any medication taken prior or during the races should be cleared by a doctor or qualified pharmacist. Any condition, which might adversely affect your driving skills, must be notified at least one (1) hour prior to the start of the event to the doctor or the organizers. Willfully withholding any information might have serious legal implications. Indemnity Form Confirmation *Yes, I confirmConfirm *I declare that the information is correct and I declare that I am fit to take part in this event.NOTE I, the undersigned, hereby agrees to indemnity found HERE We hereby certify that we have read and understand the General Competition Rules and Standing Supplementary Regulations applicable to the competition as per our current Motorsport Hand Book. We further certify that the particulars are true and correct and that the vehicle entered complies with the regulations and vehicle specifications for the particular class / category / formula. We are aware of the penalty for non-compliance as per GCR 93 to GCR 94. DRIVER Electronic Signature *Start signing your signature hereYour browser does not support e-Signature field.GUARDIAN / Parent Signature *Start signing your signature hereYour browser does not support e-Signature field.Date *Terms and ConditionsElectronic Signature Usages{name-2} Please take note of the following: My providing your signature, you are signing electronically for the following documents: ENTRY FORMNMSF PRE-RACE DECLARATIONNMSF INDEMNITY - DriverNMSF INDEMNITY - GUARDIANDeclaration for Fitness to Compete When you compete the entry, your details will be automatically generated, including your signature.Register
