2025 CCRMIT khanacross Entry Form

2025 CCRMIT Khanacross / Motorkhana Entry Form
Event Supp Regs
Download the Supps Regs - Here

(May take a minute to load, give it time)
1. Entry Details (Driver)
Driver Name*

First NameLast Name
Motorsport Australia Licence*

Licence NoExpiry
If using a one off 'Introductory Licence', enter 'INTRO' with expiry of 16/11/25 and complete and return this
Car Club*

Club NameMember NoExpiry Date
If not a member of a Motorsports Australia affliated car club. Enter CCRMIT, New, 16/11/25. As part of your entry you will be given a 1 year CCRMIT membership
Mobile No*
Email Address*
Address*

Street Address

Street Address Line 2

CityState

Post Code
Next of Kin*

NameMobileRelationship
2. Disclaimers & Forms
The following documents must be completed and emailed to entries@ccrmit.com by the 15th November or presented on the day.

1) Motorsport Australia General Disclaimer

2) Copy of Motorsport Australia Competition Licence

or fully completed Introductory Licence form

3) Passenger Ride form (For each non driving passenger participating)

4) Self-Scrutiny Statement of Vehicle Compliance (For each vehicle entering)
Security Check*
3. Payment

Please note there is a credit card surcharge to cover paypal's fees

Entry Fee - Select only one*

Junior - Come & Try$25.00AUD

For junior drivers (12-17) without a MA licence. Come & Try Level 1 licence included.

Adult - Come & Try$60.00AUD

For drivers over 18 without a MA licence. Come & Try Level 1 licence. Includes 1-year CCRMIT membership.

MA licence holder$35.00AUD

For members of MA affiliated clubs who hold an MA Non Speed or higher licence. Includes 1-year complementary CCRMIT membership if not a CCRMIT member.

Enter coupon

Subtotal $0.00AUDTax $0.00AUDTotal $0.00AUD

Pay with Credit Card

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

2025 CCRMIT Khanacross / Motorkhana Entry Form

1. Entry Details (Driver)

2. Disclaimers & Forms

3. Payment