ENTER NOW. Secure your number .
Enclose $30.00 check or money order with your application for the
fantastic,
most prestigious motocross race of the year!
RIDER PARTICIPANT CARD
APPLICATION FOR THE 2002-2003
GRAND NATIONAL CHAMPIONSHIP
Number
Requested____________ Alternate
Number______________________
Name
______________________________________________
E-Mail Address________________________
Fax No.______________________________
Date
of Birth _______________________ Phone
Number Area (________)___________________________
Address_______________________________________City ____________________State______Zip_______
To what motorcycle organizations do you
belong?_________________________________________________
Brand of Bike ________Class________Sponsors__________________________________________________
RIDER
CLASSIFICATION
MINIBIKES (MODIFIED) MOTORCYCLES(MODIFIED) STOCK & OPEN
__Teeny
Mini Mod(4-8 yrs.)
__125 Nov__Int.__Expert __Teeny Mini Stk.(4-8)
__PW50-JR50(4-8
yrs.) __250 Nov__Int.__Expert
__Mini Mini
Stk.(6-11)
__Mini
Mini 0-65cc(6-11 yrs.) __125 Schoolboy(12-15)
__Mini Stock(7-11)
__Minibike Jr. 0-85cc(7-11)
__100cc __Open 500cc __Mini Stock(12-13)
__Minibike Sr. 0-85cc(12-13)
__Over 25 Nov__Int.__Exp. __Mini Stock(14-16)
__Minibike Sr. 0-85cc(14-16)
__Over 30 Nov__Int.__Exp. __Mini
Open(7-16)
__Over 35 __Over 40
__Over 50 __125 Stk. Nov__Int
(Age Effective
__125 Open __250 Open
*NOTE: All classes are modified unless they have the word ‘STOCK’ in them.
A stock bike may be ridden in the modified class, but a modified bike may not be ridden in a stock class.
I understand that the above track and Grand National Championship and their directors will not be responsible or held
liable for any loss or damages arising by reason of accident, occurrence, injuries, or damages to myself or members of
my family and any minor child in my care while I am participating in a Grand National Championship event, whether
or not such injury, accident or damages were caused by the negligence of the above track, Grand National Championship
or any of their directors, directives, or people with whom they are associated.
Rider Participant_______________________________________
If rider participant is under 18, parent or guardian adult must sign here:
Parent Guardian____________________________________________
PLEASE MAIL APPLICATION AND $30 TO:
Jerry Surber,
Grand National Championship
Dallas, TX. 75235
e-mail: jerrysurber@sbcglobal.net Website: gncmx.com