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Farnborough District MC April SOLO - ENTRY FORM - 7th April 2019 - Abingdon
Held under the General Regulations of the MSA Ltd (incorporating the provisions of the International Sporting Code of the FIA) and the Supplementary Regulations.
Entries close on Tuesday 2nd April 2019.
Other wise phone the entry secretary for queries.
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DRIVER DETAILS
Full Name
Your answer
Option 1
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Full Postal Address with Post Code
*
Your answer
Telephone contact Numbers
*
D/E/M Day/Evening/Mobile
Your answer
Date of Birth if under 17, else ignore.
MM
/
DD
/
YYYY
eMail
*
For Entry confirmation, Final Instructions & Results
Your answer
Do you hold a current RTA (Driving) Licence?
*
Yes
No
Passenger Name (must have RTA licence) or N/A
*
ONLY "IF" driver has no RTA Licence
Your answer
Passenger Experience or N/A
*
Is passenger Experienced in Autotest or Autosolo?
Yes
No
Not Applicable
CLUB DETAILS
You will need to show a valid Club Membership card at event registration.
Motor Club
*
You must be a Member of an MSA recognised Club. Re read the regulations if you need to join a club, or contact FDMC Membership sec to join quickly.
Farnborough District MC
CSMA
Dolphin MC
MGCC
Basingstoke MC
Southsea MC
Bournmouth &DCC
Sutton & Cheam MC
Oxford MC
Falcom MC
Southern Car Club
NEXT OF KIN DETAILS
Only to be used in the case of an emergency
Next of Kin : Name & Relationship
*
Your answer
Next of Kin Address & Telephone details
*
Your answer
CAR DETAILS
Make
*
Your answer
Model
*
Your answer
Registration Number
*
Your answer
CCs
*
Cubic capacity e.g. "1598" , just enter the numeric digits
Your answer
Fuel
*
Petrol
Diesel
Other:
Forced Induction (Turbo or Supercharged)
*
Yes
No
Other:
ENTRY DETAILS
Class
*
You are confirming that your car is eligable for this class. See notes in Regs.
A = Historic, registered before 1 Jan 1980
B = Saloon / Estate / 4 seat coupe, up to 1400cc
C = Saloon / Estate / 4 seat coupe, 1401cc up to 1800cc
D = Saloon / Estate / 4 seat coupe, over 1800cc
E = Production (open and fixed roof) 2 seat sports cars
F = All other cars, incl low volume sports cars, kit cars and others ineligible for A to E
Car Sharing / Double Driven
*
If "yes", state Name of other Driver, else enter "No". Each driver must make an individual entry form each.
Your answer
PAYMENT DETAILS - £40 (£10 for under 21s)
Paypal - Online Payment via "PAY-NOW" button from Event Entry Page. You can use Paypal with a Credit or Debit card and you do not need a PayPal account.
Cheques - Payable to "Farnborough District Motor Club"
Payment Method
*
PayPal
Cheque sent and payable to FDMC
Other:
Please read the Declaration Page from the Entry Regulations
*
I have read and accept the declaration conditions as from the entry regulations.
Required
Drivers under the age of 18 on the day of the event.
This person is your Parent/Gardian and will have to sign for you at Registration, Enter their Name, Address, Tel and relationship below.
Your answer
DECLARATION of INDEMNITY
ENTER THE EVENT
ENTER THE EVENT Please check your form and then Click the Submit button below. Enter any further details below.
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