Is this a Renewal Application?
Select one
Yes
No, I am a new applicant
Licence Type
Select one
Area 27 Lapping Licence
Dutchway Enduro Licence
Road Racing Novice
Road Racing Senior
ORRA 27 Instructor Licence
Unsure which grade you qualify for? Contact Maxx with your racing and driving history before applying.
Are you an Area 27 Member?
Select one
Yes
No
Area 27 Membership Number (Members Only)
Name - First
Name - Middle
Name - Last
Contact Number
Emergency Contact
Emergency Contact Phone
Driver's Licence Number
Province
Area 27 Circuit Experience
Instructor or Coaching Experience
Race Class Type (If Known)
Car Number (If Applicable)
Transponder Number (If Known)
Additional Race Information (Optional)
Performance Driving Experience
Performance Driving School or Accreditation
Upload proof of qualifying experience
Attach a race logbook, school certificate, previous licence, official race results, or other relevant proof. Renewal applicants must include their previous ORRA 27 licence. PDF, PNG, or JPG files only; links are not accepted. You may add up to 10 files across the application, with a combined size of 10 MB or less.
Photograph for staff records (optional)
A photo is not needed for the digital licence. You may upload one for the staff record if you wish.
How this section works: complete the online questions below. Download the physician package, have your doctor complete and sign it, keep your copy, and upload the current signed package with this application. The age-based schedule below determines when a new physician examination is required.
Self-Declaration Status
Select one
I am completing the online self-declaration below
Physician Package Status
Select one
Completed, signed and uploaded with this application
Completed and ready to upload
Appointment scheduled with my physician
I need to book the physician examination
Current signed physician medical
Attach your current physician-signed ORRA 27 package or another motorsports-authority medical when accepted for your renewal. PDF, PNG, or JPG files only; links are not accepted. You may add up to 10 files across the application, with a combined size of 10 MB or less. Keep your original medical documents.
ORRA 27 medical-validity note from the application: applicants aged 50 and under must submit a physician-completed medical every 5 years; applicants aged 51 to 65 must submit one every 2 years; applicants aged 66 and older must submit one every year. Upload your retained current signed package with each annual application or renewal.
Frequent or severe headaches
Select one
Yes
No
Unconsciousness for any reason
Select one
Yes
No
Dizziness or fainting spells
Select one
Yes
No
Epilepsy or Seizures
Select one
Yes
No
Psychiatric / Mental Health Problems
Select one
Yes
No
Allergies
Select one
Yes
No
Eye trouble (except for glasses)
Select one
Yes
No
Asthma
Select one
Yes
No
Diabetes
Select one
Yes
No
Anemia, or other blood diseases including abnormal bleeding
Select one
Yes
No
Admission to a hospital in the last 12 months
Select one
Yes
No
Amputations and or physical disability
Select one
Yes
No
Previous denial(s) due to medical reason(s)
Select one
Yes
No
Tetanus shot
Select one
Yes
No
Coronary Artery disease or Angina
Select one
Yes
No
Valve disease
Select one
Yes
No
Abnormal Cardiac Rhythms
Select one
Yes
No
High Blood Pressure
Select one
Yes
No
Operation(s) involving Eyes, Brain, Heart, Nerves, Blood Vessels, or Bones
Select one
Yes
No
Other Heart Issues
Select one
Yes
No
Other Heart Issues
Applicant's Signature
Clear Signature
Draw with a mouse, trackpad, or finger.
Signature of Parent/Guardian (if under 18 years old)
Clear Signature
Required only for applicants under 18.
Submitting and paying for an application does not guarantee that ORRA 27 will issue a licence. Applicants must meet the qualifications and provide complete, relevant documents. The application fee is non-refundable, including if the application is denied.
After submitting this form, you will be taken to secure Shopify checkout to pay the $50 lapping or Dutchway Enduro fee, or the $80 Road Racing Novice, Senior, or Instructor fee. Your application enters review only after payment is confirmed. Do not enter credit-card details in this form.
Complete the secure verification before sending.
Submit Licence Application Complete the required fields, sign the declaration, and attach your current signed medical and proof of qualifying experience before submitting. A photograph is optional and is not shown on the digital licence. Incomplete applications cannot be submitted. Need the doctor form first? Download the physician package , have it signed, retain your copy, and upload the current copy above.
