Clone of SA Hillclimb Championship 2026

DRIVERS SPONSORSHIP FORM- Location: Shell V-Power Motorsports Park, Eastern Circuit - 543 Dukes Hwy Tailem Bend SA 5260
Driver Information
Driver's Name

First Surname
Date of Birth

DayMonthYear
Date
Address

Street Address

SuburbState

Post Code
Mobile Number
Please enter a valid phone number.Format: 0000 000 000.
Email
example@example.com

Emergency Contact / Medical Details
Emergency Contact Person

First NameLast Name
Mobile Number
Please enter a valid phone number.Format: 0000 000 000.
Relationship to Driver
Drivers Medical Conditions
Does the competitor have any allergies, chronic illness, or medical conditions? If yes , please describe.

Upload MA Licence & Club Membership below.
Motorsport Australia Licence

upload current MA licence - This must show licence number and expiry date
Cancelof
Motorsport Australia Number
Expiry Date

MonthDayYear
Date
Club Membership card

upload current Club Membership
Cancelof
Club Membership Number
Expiry Date

MonthDayYear
Date

Entry Fee and Payment details - Per Driver

Please make sure you use your surname as reference for payment so we call allocate funds correctly.

Driver Sponsorship

This guarantees early entry if submitted prior to 15th of June 2026. This will give you media coverage on all our platforms.

$550.00 AUD Quantity

Driver Sponsorship with Carport

This comes with a 240v carport - numbers limited

$750.00 AUD Quantity

Total

CLASSES
CLASS ENTERING

Make sure you enter the correct class and category for your vehicle. It is your responsibility to select the correct class
Class eg ; 2A sports cars Open/closed Category eg: 2001-400cc
Log Book Number
Car Details
Model
Main Colour
Duel Entered Vehicle

All drivers must complete separate entry forms
Additional drivers sharing the same vehicle

Parent / Guardian Details

(all juniors aged 14-17 must have a parent of guardian signature and they must be present at all times at the event, attend drivers briefing, scrutineering and booking in with Junior entrant.)
Parent/ Guardian full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/ Guardian's Signature

Photographic Release
I give permission to the organisers of Hill Climb for the use of my photographs that are taken by staff in order to use for social media.
Sponsors details
Sponsors / Company name
Please provide details of Sponsoring company for publication
Details for Invoice if required
Please provide details if you require an invoice
Drivers Signature

I hereby acknowledge that the information given above is accurate and
Signature
Should be Empty:

DRIVERS SPONSORSHIP FORM- Location: Shell V-Power Motorsports Park, Eastern Circuit - 543 Dukes Hwy Tailem Bend SA 5260