FDMC Dimanche Sprint- ENTRY FORM - 23rd April 2017
Held under the General Regulations of the MSA Ltd (incorporating the provisions of the International Sporting Code of the FIA) and the Supplementary Regulations.

If you have any problems, Please telephone the Entries Secretary.

CLOSING DATE = See regulations, or just yourself entered here,
or telephone the Entry Secretary.

DRIVER DETAILS
Full Name *
Your answer
Full Postal Address with Post Code *
Your answer
Telephone contact Numbers *
D/E/M Day/Evening/Mobile
Your answer
eMail *
For Entry confirmation, Final Instructions & Results
Your answer
CLUB & CHAMPIONSHIP DETIALS
Motor Club *
You must be a Member of an MSA recognised Club, affiliated to one of the following regions. Re read the regulations if you need to join a club, or join FDMC.
MSA Licence Number *
You will need to show your licence at event registration.
Your answer
Championship Details
You will need to show a valid championship card at event registration.
Championship Registration Number(s)
Save time on the day, please tell us now.
Your answer
Have you ever held an RTA (Driving) Licence (Reg S 7.1.6) *
NEXT OF KIN DETAILS
Only to be used in the case of an emergency
Next of Kin : Name & Relationship *
Your answer
Next of Kin Telephone details *
Your answer
CAR DETAILS
Make & Model *
Your answer
Colour *
Your answer
Registration Number for Road going classes *
if not road going, enter "NA"
Your answer
CCs *
EXACT Cubic capacity e.g. "1598" , just enter the numeric digits
Your answer
Forced Induction *
Turbo or Supercharger ?
Rotary Engine *
Fuel *
Class Entered *
You are confirming that your car is eligable for this class. See notes in Regs.
Car Sharing / Double Driven *
If "yes", state Name of other Driver, else enter "No"
Your answer
PAYMENT DETAILS
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 MC"
Untitled Question Cheque *
DECLARATION of INDEMNITY
Please read the Declaration Page 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
ENTER THE EVENT
ENTER THE EVENT Please check your form and then Click the Submit button below. Enter any further details below.
Your answer
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