| Regulations | Entry Form | Final Instructions | Results | Home |
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Driver |
Navigator | |
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Name |
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Address |
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Tel. No. |
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Club |
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Email Addresses |
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Next of Kin: Name Tel. No. |
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| Additional Navigators: | |
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Vehicle Details |
Name and Address of Insurers |
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Make: | |
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Model: | |
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Colour: | |
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Registration: |
| Class Entered? | Novice | Semi-Expert | Expert |
| Correspondence to: | Driver | Navigator |
| Tick | Please return to: | |||
| [ | ] | Entry Fee | £6.00 | Doug Robinson |
| [ | ] | Late entry supplement | £4.00 | 84 Commercial Street |
| [ | ] | WCC Membership (driver) | £11.00 | Bitterne |
| [ | ] | WCC Membership (navigator) | £11.00 | Southampton |
| SO18 6NJ | ||||
| Total Enclosed | £ | |||
Please make cheques payable to "Windsor Car Club Ltd".
Remember to sign the indemnification below
Please sign the declaration below, complete the details above and return to the Entries Secretary with your entry fee.
"I have read the Supplementary Regulations issued for this event and agree to be bound by them and by the General Regulations of The RAC Motor Sports Association Ltd. In consideration of the acceptance of this entry and my being permitted to take part in this event, in respect of any parts of the event not held on a publicly adopted road, I agree to save harmless and keep indemnified The RAC Motor Sports Association Ltd., such Person, Persons or Body as may be authorised by The RAC Motor Sports Association Ltd. to promote or organise this event and their respective Officials, Servants, Representatives and Agents together with other Competitors and their respective Servants, Representatives, and Agents, from and against all actions, claims, costs, expenses and demands in respect of Death of or Injury to or Damage to the property of myself, my Driver(s), Passenger(s), Mechanic(s) or associated personnel, arising out of or in connection with this entry or my taking part in this event.
I declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which valid for such part of this event as shall take place on roads as defined by law."
Driver:
Signed:
Date:
State your age if you are under 18:
Navigator:
Signed:
Date:
State your age if you are under 18:
If the entrant, driver or navigator is under 18 years of age, this form must be countersigned by the appropriate parent or guardian.
Parent or Guardian
Signed:
Date:
Full Name:
Address:
Official Use Only:
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Entry Number |
Date Received |
Class |
Membership Required |
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