Shannons Targa Rallysprint Series Entry Form
EVENT: 2019 Shannons Targa Rallysprint Series at The Perth Motorplex, Kwinana

Please complete this form with all relevant details correctly formatted to ensure your entry is accepted.

Refer to Section 7.4 in the Supp Regs for Direct Deposit banking details and while you are there please take a couple of minutes to read the rest of the Supp Regs. Thank you. Your Entry Fee MUST be received prior to Close of Entries for each round unless prior arrangements have been made.

Supp Regs can be downloaded from www.rallysprints.com/supp-regs

Please note: You MUST click on the SUBMIT button on the last page after the Sponsor Logos. If you do not then none of the details will come through.

DRIVER DETAILS
Driver 1st Name *
Your answer
Driver Surname *
Your answer
Driver Email *
Your answer
Driver Mobile No *
Your answer
Driver already has a CAMS licence *
Please tick appropriate box
Driver CAMS Licence Number
If you don't have a CAMS Licence go to next field...
Your answer
Driver Emergency Contact *
Please provide the Name and Mobile number for your next of kin in the event of an emergency
Your answer
CO-DRIVER DETAILS
Co-Driver 1st Name
Your answer
Co-Driver Surname
Your answer
Co-Driver Email
Your answer
Co-Driver Mobile No
Your answer
Co-Driver CAMS Licence Number
If your Co-Driver does note have a CAMS Licence then leave blank.
Your answer
Co-Driver Emergency Contact
Please provide the Name and Mobile number for your Co-Driver's next of kin in the event of an emergency
Your answer
Additional Co-Drivers? *
Note: Changing Co-Drivers during the event will exclude both Co-Drivers from obtaining WA Targa Cup points
Next
Never submit passwords through Google Forms.
This form was created inside of Targa West.