2025 All Bike – Benaraby Dragway

Date of Event *

Name *

First

Last

Email *

Phone *

Address *

Date Of Birth *

Licence Type *

If you have a valid IHRA Licence, you must use that. Otherwise, please select Drivers Licence.

IHRA Licence Number *

Please enter your IHRA Licence number number here.

Drivers Licence Number *

Please enter your drivers licence here

Click here to purchase the IHRA Benaraby Dragway event licence: IHRA Benaraby Dragway event licence.

IHRA Day/Event Licence *

Click or drag a file to this area to upload.

I confirm that I have purchased the IHRA Benaraby Dragway event licence and attached to nomination. You will be asked to show your IHRA Event Licence email at the office upon check in.

Bike Make and Model *

Engine Capacity *

Sponsors

Please enter any sponsors you have here.

Bracket (Please Select 1 Only) *

Would you like to race in a 2nd bracket? *

Bike 2 Make and Model *

Bike 2 Engine Capacity *

Please select your 2nd Bracket *

Would you like to race in a 3rd bracket? *

Bike 3 Make and Model *

Bike 3 Engine Capacity *

Please select your 3rd Bracket *

Are You a CQDRA Member? *

Nomination Fee Member (including gate entry) *

Both Friday Off Street & All Bikes (CQDRA Member) – $160.00
Junior (Member) – $80.00

Saturday ONLY Nomination Fee Member (including gate entry) *

Saturday Only All Bikes (CQDRA Member) – $130.00
Saturday Only Junior (Member) – $50.00

Friday ONLY Nomination Fee Member (including gate entry) *

Friday Off Street (CQDRA Member) – $60.00

Nomination Fee Non-Member (including gate entry) *

Both Friday Off Street & All Bikes (Non Member) – $180.00
Junior (Non Member) – $100.00

Day Licenses will be paid at the office on race day and will be required for all racers not licensed with IHRA.

Saturday ONLY Nomination Fee Non-Member (including gate entry) *

Saturday All Bikes (Non Member) – $150.00
Saturday Junior (Non Member) – $70.00

Day Licenses will be paid at the office on race day and will be required for all racers not licensed with IHRA.

Friday ONLY Nomination Fee Non Members (including gate entry) *

Friday Off Street – $70.00

Day Licenses will be paid at the office on race day and will be required for all racers not licensed with IHRA.

Nomination Fee – Additional Bracket *

Both Friday Off Street & All Bikes – Additional Bracket – $65.00

Nomination Fee – Additional Bracket *

Both Friday Off Street & All Bikes – Additional Bracket – $65.00

Crew Pass – Friday

Price: $10.00

For Friday Only

Crew Pass – Saturday

Price: $15.00

For Saturday Only

Crew Pass – Both Friday & Saturday

Price: $20.00

For Both Friday & Saturday

Will you be bringing a pet to the track? *

No
Yes

If Yes, you agree to the pet policy below.

CQDRA Pet Policy Agreement

Track regulations *

I agree to the Track Regulations

You can access the Benaraby Dragway Track Regulations here: Benaraby Dragway Track Regulations

IHRA Rules & Regulations *

I agree to all IHRA Rules and Regulations

You can access the IHRA Australia rules and regulations here – IHRA

PARENT/GUARDIAN CONSENT – PERSONS UNDER 18 YEARS OLD

I am the parent/guardian* of the above-named (“the minor”) who is under 18 years old. I have read this document and understand its contents, including the exclusion of liability and assumption of risk, and have explained the contents to the minor. I consent to the minor attending/participation in the event at his/her own risk.

Parent / Guardian Name

First

Last

Next of Kin *

First

Last

Next of Kin contact number

I confirm that the information provided in this nomination is true, complete, and correct to the best of my knowledge. *

Yes

Total

Item Quantity Qty Total

There are no products selected.

Nomination Fee Member (including gate entry) – Both Friday Off Street & All Bikes (CQDRA Member) 1 $160.00

Nomination Fee Member (including gate entry) – Junior (Member) 1 $80.00

Saturday ONLY Nomination Fee Member (including gate entry) – Saturday Only All Bikes (CQDRA Member) 1 $130.00

Saturday ONLY Nomination Fee Member (including gate entry) – Saturday Only Junior (Member) 1 $50.00

Friday ONLY Nomination Fee Member (including gate entry) – Friday Off Street (CQDRA Member) 1 $60.00

Nomination Fee Non-Member (including gate entry) – Both Friday Off Street & All Bikes (Non Member) 1 $180.00

Nomination Fee Non-Member (including gate entry) – Junior (Non Member) 1 $100.00

Saturday ONLY Nomination Fee Non-Member (including gate entry) – Saturday All Bikes (Non Member) 1 $150.00

Saturday ONLY Nomination Fee Non-Member (including gate entry) – Saturday Junior (Non Member) 1 $70.00

Friday ONLY Nomination Fee Non Members (including gate entry) – Friday Off Street 1 $70.00

Nomination Fee – Additional Bracket – Both Friday Off Street & All Bikes – Additional Bracket 1 $65.00

Crew Pass – Friday 0 $0.00

Crew Pass – Saturday 0 $0.00

Crew Pass – Both Friday & Saturday 0 $0.00

Square surcharge 1 $0.00

Subtotal

Total $0.00

Payment method *

Credit card via Square – surcharge applies 2.25%*
Bank transfer

Square *

Card

Name on Card

Square surcharge *

Price: $0.00

Payment details for nomination

To secure your race nomination please arrange a bank deposit within 24 hours or pay via card through above field: Westpac Bank BSB: 034 126 Account: 232427 Ref: Surname/bracket