Farnborough District Motor Club - Autumn Antics - ENTRY FORM - 5th November 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.

Closing Date = Midnight Tuesday 31st October, otherwise call the Entry Secretary.

DRIVER DETAILS
Full Name *
Your answer
Postal Address *
Your answer
Telphone Numbers *
Prefix with D/E/M for Day, Evening, Mobile numbers
Your answer
eMail *
For Entry confirmation, Final Instructions & Results. Ensure it is correct.
Your answer
CLUB DETAILS
Member of Motor Club *
Club Membership Number *
You will need to show a valid membership card at Registration
Your answer
NEXT OF KIN DETAILS
Next of Kin : Name and Relationship. *
Only to be contacted in the event of an emergency
Your answer
Next of Kin Telephone details. *
Your answer
CAR DETAILS
Make *
Your answer
Model *
Your answer
Cubic capacity in CCs *
Your answer
Length *
in feet and inches please, check on Wikipedia if unsure.
Your answer
ENTRY DETAILS
Class *
You are confirming that your car is eligable for this class. See notes in Regs.
Clubsport or PCA *
PCA is for under 17s only.
Divers age, if entering the PCA
as of on day of event.
Your answer
Car Sharing / Double driven *
If 'Yes', please declare who the other driver is, otherwise say 'No'
Your answer
PAYMENT DETAILS
Tick one to confirm how you will pay your £40 Entry Fee. *
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
Please check your form and then Click the Submit button below. Enter any further details below.
Your answer
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