EmailMe Form - Blackpalfrey Event Entry Form

Event *
11th October 12 car
1st November 12 car
*** FROM 1st JANUARY 2020 both Driver and Navigator will require a Motorsport UK licence - at a minimum the new, free RS clubmans licence. Please visit https://www.motorsportuk.org/2020-rs-clubman-licence/
Driver *
First Last
Driver's Motorsport UK Licence No.
Required from 1st January 2020
Navigator *
First Last
Navigator's Motorsport UK Licence No.
Required from 1st January 2020
Driver's Address and Postcode *
Driver's Club
Navigator's Club
Primary Email *

Confirm
Navigator's Email
Car Make / Model *
Car Year of Registration *
Registration Number *
Do you have your own insurance for competitive events? *
Yes
No
Entry Fee Payment Method *
On-line Bank Transfer
Note: Due to the current situation payment by bank transfer is the only option inline with Motor Sport UK guidelines. Bank details will follow on the next page when you submit your entry.
Entry Fee (£15.00)
REIS Insurance (£17.00)