2017 Australian HPV Super Series

When you use the submit button at the bottom of this form, a confirmation code will be displayed. 
You will require this confirmation code to finalise your registration. 

Team Details
Entrant (Institution or Group) Name *  
Team (Vehicle) Name    
Team Manager Title    
Team Manager Surname *  
Team Manager First Name *  
Postal Address (street) *  
Postal Address (suburb) *  
State / Province * Other ( specify )  
Postcode / ZIP *  
Telephone (AH) *  
Telephone (Bus) *  
Telephone (Mobile) *  
e-mail *  

* = Required Field

 

Entry Fees

 

Date

Venue Registration Fee  
31st March - 1st April 2017 Mount Gambier 8 hour - Series Round 1 $350.00 + gst  
6th - 7th May 2017 Loxton 6 hour - Series Round 2 $350.00 + gst  
16th - 18th June 2017 CATEGORY 4 ONLY Victoria Park 6 hour - Series Round 3 $450.00 + gst  
16th - 18th June 2017 CATEGORY 1,2 and 3 ONLY Victoria Park 6 hour - Series Round 3 $450.00 + gst  
28th - 30th July 2017 CATEGORY 4 ONLY Victoria Park 6 hour - Series Round 4 $450.00 + gst  
28th - 30th July 2017 CATEGORY 1,2 and 3 ONLY Victoria Park 6 hour - Series Round 4 $450.00 + gst  
19th - 20th August 2017 Busselton Pedal Prix, Busselton WA 6 hour - Non Series Race $350.00 + gst  
21st - 24th September 2017 Murray Bridge 24 hour - Series Round 5 $550.00 + gst  
 

Entrant Type

 
Please select the best description for your team:

  School - Government (Subcategory = S)

  School - Non Governmen (Subcategory = S)

  TAFE (Subcategory = C)

  University (Subcategory = C)

  Community - Made up of members from various schools / institutions (Subcategory = C)

  Non Institutional (Subcategory = C)

If entering as a School team ALL members MUST be from the same school else choose Community.

Age Category

 
Please select the age category of your team:

  Primary (Category 1. School and Community)

  Junior Secondary (Category 2. School and Community) 

  Senior Secondary (Category 3. School and Community) 

  Open (Category 4. Community / Non Institutional only) 

Other

 
Please include our team in the following category(s):

  All Female Team (Note : Must compete as All Female EVERY round) 

  Masters Category - Cat 4, max 10 riders, all riders over 30. (Note : Must compete as Masters EVERY round) 

   
Invoice Total   AUD$ inc gst
     
I have read and understand the Conditions of Entry