Pongakawa Trails Sign On

1

Name* This field is required.

First Name

Last Name

2

Date Of Birth* This field is required.

Date

3

Your Mobile* This field is required.

4

Rego of vehicle you are travelling in* This field is required.

5

Medical conditions or allergies?

6

Emergency Contact* This field is required.

7

Are You Riding Alone?

8

U16 Riders In Your Care

9

Do you agree to comply with our rules as per signage at the bike office and understand the risks associated with Dirt Biking?* This field is required.