OPEN PRACTICE REGISTRATIONSunday, June 28, 2026 | 8:00 AM – 3:00 PM Open Practice RegistrationThis registration form is for non-members participating in a Shasta SuperMoto Open Practice Day. All riders must complete this registration and submit payment online before participating.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.How many Adult Riders are being registered and paid for on this Open Practice Registration? *— Select Choice —None – $0.00One – $50.00Two – $100.00Three – $150.00Four – $200.00Five – $250.00Six – $300.00How many Minor Riders (Under 18) are being registered and paid for on this Open Practice Registration? *— Select Choice —None – $0.00One – $50.00Two – $100.00Three – $150.00Four – $200.00Five – $250.00Six – $300.00Responsible Party Information *FirstLastAddress *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip Code Experience Responsible Adult Phone *Email *EmailConfirm EmailI am: *An adult rider participating in this eventThe parent/legal guardian of one or more minor riders participating in this eventEmergency Contact Information *FirstLastEmergency Contact Phone *Adult Rider Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerAdult Rider #2 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerAdult Rider #3 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day.Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerAdult Rider #4 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerAdult Rider #5 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day.Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerAdult Rider #6 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. All riders must sign a waiver and receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Phone *Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider #2 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider #3 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider #4 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider #5 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerMinor Rider #6 Information *FirstLastImportant: Rider registration does not replace the Shasta SuperMoto Waiver. A parent or legal guardian must sign a waiver on behalf of each minor rider. Minor riders must receive a waiver wristband before entering the track area on event day. Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Bike Information *Bike Make/Model, Engine Size, and Bike #Experience Level *— Select Choice —ProAdvanced/ExpertIntermediateBeginnerParent / Guardian Certifications *I certify that I am the parent or legal guardian of the minor rider and have authority to complete this registration.Total$0.00Stripe Credit Card *Submit
