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Suzuki - TSSR 2003 (Page 2)

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Suzuki - TSSR 2003
CIRCLE THE MODEL(S) YOU RACE
CIRCLE THE MODEL(S) YOU RACE
LAST 6 DIGITS OF THE VIN (FRAME) NUMBER (S)
LAST 6 DIGITS OF THE VIN (FRAME) NUMBER (S)
VIN # __ __ __ __ __ __
VIN # __ __ __ __ __ __
Please complete a new form if you buy any additional current model racebikes
RACING INFORMATION
RACING INFORMATION
City
State
SPONSORED RIDER DECLARATION
SPONSORED RIDER DECLARATION
Date
Address
State
P/Code
I HAVE READ AND UNDERSTAND THE FOREGOING RELEASE
I HAVE READ AND UNDERSTAND THE FOREGOING RELEASE
Date
Date
SEND COMPLETED FORM TO:
SUZUKI AUSTRALIA
Attn: Motorcycle Marketing
PO BOX 84
LAVERTON
VIC 3028
Your Suzuki Dealer
Racing Classification(s)
M.A License No.
RM250 RM125 DR-Z400 DR-Z400E DR-Z250 GSX-R1000 GSX-R750 GSX-R600
Racing #
Racer's Signature
(If the motorcycle is owned by another individual, the "sponsor" must complete this section.)
I have agreed to sponsor the rider listed on this form. I am the registered owner of the vehicle and understand that no additional
persons(s) other than indicated will be paid contingency from Suzuki Australia.
(if racer is under 18 yrs)
Guardian's Signature
Owners Signature
Owner's Name

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