Mosport Karting Centre » MIKA Event Registration

M.I.K.A EVENT
Choose the event you are registering for from the check list.*
- M.I.K.A RACE 6
- M.I.K.A RACE 7
- M.I.K.A RACE 8
- M.I.K.A RACE 9
- M.I.K.A RACE 10
Personal Information
Driver's Name*
Email*
Address*
Street Address Address Line 2 City Province Postal Code
Phone #1*
Phone #2
Emergency Contact - Name*
Emergency Contact - Phone Number*
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Karting Information
Please ensure that you use the Kart number issued to you when you purchased your National Karting Licence. The kart number issued to you is on the back of your National Karting Licence
Your Transponder Number
Club Membership Affiliation
*if you are affiliated to another team or club from another track please indicate it here.
Mechanic Name
Classes
1st Entry ($90.00 CAD + HST)*
Kart Number (1st Entry)
2nd Entry ($80.00 CAD + HST)
Kart Number (2nd Entry)
MANDATORY FORM/WAIVERS
Please ensure that you print, sign/fill out all applicable waivers and the tech form below.
- General Waiver & Release Form
- Parental Consent Form
- Minor Participant Form
- Technical Inspection Self-Declaration Form
Additional Options
Pre-event practice on Friday ($65 + HST)
Price: $ 65.00 CAD Quantity:
Pre-Order Race Day Fuel (FUEL VP CAN - 5 GAL - $120.00 + HST)
Price: $ 120.00 CAD Quantity:
Pre-Order Race Day Oil (MOTUL OIL 2T - $32.04 + HST)
Price: $ 32.04 CAD Quantity:
Pre-Order Tires
VEGA BLUE SLICK 6.50 / 4.50 SET ($255.00 + HST + TIRE TAX)
Price: $ 255.00 CAD Quantity:
VEGA BLUE SLICK 4.50 / 4.50 SET ($240.00 + HST + TIRE TAX)
Price: $ 240.00 CAD Quantity:
VEGA W5 RAIN TIRE SET ($295.00 + HST + TIRE TAX)
Price: $ 295.00 CAD Quantity:
BRIDGESTONE YLR 7.10 / 4.50 SET ($285.00 + HST + TIRE TAX)
Price: $ 285.00 CAD Quantity:
BRIDGESTONE YLR 4.50 / 4.50 SET ($269.00 + HST + TIRE TAX)
Price: $ 269.00 CAD Quantity:
BRIDGESTONE YLP RAIN TIRE 650 / 450 SET ($305.00 + HST + TIRE TAX)
Price: $ 305.00 CAD Quantity:
Note: All Tires, Fuel & Oil ordered here will be available onsite at the track registration check-in
Total
Total payable amount
TIRE TAX
Price: $ 0.00 CAD
HST 13%
Price: $ 0.00 CAD
Total including HST and Tire Tax (if applicable)
$ 0.00 CAD
Comments
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MIKA Event Registration

M.I.K.A EVENT

Personal Information

Karting Information

Classes

MANDATORY FORM/WAIVERS

Additional Options

Pre-Order Tires

Total