Rallycross Online Entry Form

RALLYCROSS ENTRY FORM

PLEASE NOTE:
Before completing this Entry Form, please see "Supplementary Regulations" AND "Disclaimer"

* Only ONLINE Entries will be accepted.
* Only ONLINE Payment will be accepted.
* Only ONLINE (JPG, PNG or PDF files) Driver's Club Member AND Motorsport Australia Licenses will be accepted.

= required

Email:

RALLYCROSS 2020

Date - Saturday, 3 October 2020

Motorsport Australia Permit Number - 520/0410/06

VEHICLE DETAILS

Make & Model
Year
Log Book Number (if applicable)
Body Type
Turbo or Subercharged
Car Class

DRIVER DETAILS

First Name
Surname
Address
Town / Suburb
State
Postcode
Email Address
Mobile Number

EMERGENCY CONTACT DETAILS

First Name
Surname
Mobile Number

LICENSE DETAILS

Car Club License	In case of any difficulties uploading your file, please email your documentation directly to aaronbowering@yahoo.com.au
Car Club Name
Car Club Member Number
Motorsport Australia Licence Number

TERMS AND CONDITIONS

Supplementary Regulations	I have read and understand the Supplementary Regulations
Disclaimer Understanding	I have read, understood, acknowledge and agree to the risk warning, disclaimer and indemnity document including the exclusion of statutory guarantees, warning, assumption of risk, release and indemnity. (This document is on the website with the supplementary regulations)