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Blackpalfrey Event Entry Form
Make a provisional entry which will be confirmed when the entry fee has been received.
Event
*
19th June 2022 Regularity Run
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
Please select
Blackpalfrey
Weald MC
HRCR
None of the above
Navigator's Club
Please select
Blackpalfrey
Weald MC
HRCR
None of the above
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 (£18.50)
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