REIS Additional Insurance Cover - Falcon Motor Club Ltd - March Hare Classic Trial - Sunday 4th March 2018
ENSURE YOU COMPLETE THIS FORM ACCURATELY - ANY PROBLEMS CONTACT THE EVENT SECRETARY
Driver Name *
Your answer
Address *
Give your full address with post code
Your answer
Contact Number *
Give your telephone number
Your answer
Date of Birth *
Your answer
Vehicle Make/Model *
Ensure this is the vehicle you will be driving on the event
Your answer
Registration Number *
Your answer
Confirmation *
Ensure you check ALL the boxes - any problems with this this please contact the event secretary - Anyone aged less than 19 years old will also be accepted at the same price should their co-driver be a more senior member of their family over 25.
Required
Declaration *
Carefully read your answers & make any corrections
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