Rally Sprint Online Entry Form

2020 PMD Race Products Forest Sprint

= required

2020 PMD RACE PRODUCTS FOREST SPRINT

Saturday, 15th and Sunday, 16th August 2020

MA Permit # - 520/1608/01

COMPETITOR/CAR OWNER DETAILS

Competitor First Name
Competitor Surname
Competitor Address
Competitor Suburb/Town
Competitor State	- select - Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Competitor Postcode
Competitor Mobile Tel. #
Competitor Home Tel. #
Competitor Work Tel. #
Competitor Email
Competitor MA Licence #
Competitor MA Licence Type
Competitor MA Licence Expiry
Competitor MA Licence Upload	I have emailed my documentation directly to aaronbowering@yahoo.com.au

DRIVER DETAILS

Is the Driver the same as the Competitor/Car Owner?	Yes No
Driver First Name
Driver Surname
Driver Address
Driver Suburb/Town
Driver State	- select - Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Driver Postcode
Driver Mobile Tel. #
Driver Home Tel. #
Driver Work Tel. #
Driver Email
Driver Civil Licence #
Club Membership #
Club Membership	I have emailed my documentation directly to aaronbowering@yahoo.com.au
Driver MA Licence #
Driver MA Licence Type
Driver MA Licence Expiry
Driver MA Licence	I have emailed my documentation directly to aaronbowering@yahoo.com.au
Emergency Contact Name
Emergency Contact Mobile #
Supplementary Regulations	I have read and understand the Supplementary Regulations.
Disclaimer	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.

CO-DRIVER DETAILS

Co-Driver First Name
Co-Driver Surname
Co-Driver Address
Co-Driver Suburb/Town
Co-Driver State	- select - Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia
Co-Driver Postcode
Co-Driver Mobile Tel. #
Co-Driver Home Tel. #
Co-Driver Work Tel. #
Co-Driver Email
Co-Driver Civil Licence #
Co-Driver Club Membership #
Co-Driver Club Membership	I have emailed my documentation directly to aaronbowering@yahoo.com.au
Co-Driver MA Licence #
Co-Driver MA Licence Type
Co-Driver MA Licence Expiry
Co-Driver MA Licence	I have emailed my documentation directly to aaronbowering@yahoo.com.au
Co-Driver Emergency Contact Name
Co-Driver Emergency Contact Mobile #
Supplementary Regulations	I have read and understand the Supplementary Regulations.
Disclaimer	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.

VEHICLE DETAILS

Vehicle Make
Vehicle Model
Vehicle Colour
Vehicle #
Vehicle Year of Manufacture
Vehicle Registration #	If applicable.
Vehicle Registration Expiry	If applicable.
Engine Capacity (CCs)	Please enter a 4-digit number.
Turbo	Yes No
Supercharge	Yes No
Drive Type	2WD 4WD
MA Log Book #
MA Log Book	In case of any difficulties uploading your file, please email your documentation directly to aaronbowering@yahoo.com.au I have emailed my documentation directly to aaronbowering@yahoo.com.au
Vehicle Class	P1 - up to 1400cc P2 - over 1400cc, up to and including 1600cc P3 - over 1600cc, up to and including 2000cc P4 - 2WD over 2000cc P5 - 4WD over 2000cc (not meeting P6 requirements) P6 - 4WD over 2000cc (older 4WDs as per Group 3C PRC Section 2.1) PRC Classic Club Rally Cars Super 2000 G2 G4 AP4 R5 Invitational Classic Rally Cars
	SUBMIT ENTRY