Motorsport New Zealand

CLUBSPORT LICENCE APPLICATION FORM

Personal Details

First Name: *
Middle Name:
Last Name: *
Date Of Birth: *	(dd/mm/yyyy) view note
	Date of Birth (to be used as identification) - All applicants who are under the age of 18 years at the time of first application must ensure the MotorSport New Zealand (Inc) Indemnity Form A001A is completed and signed by a parent or legal guardian. Copies of the Indemnity Form are available from the MotorSport Office or your club.
Country Of Passport: *	view note
	Country Of Passport - Applicants born overseas are required by the FIA to obtain a clearance from the Motorsport authority for the country in which they hold their passport. This clearance is required regardless of whether or not the applicant has previously competed in any form of motor sports.
Gender:	Male Female
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