EmailMe Form - Tour of Kent - 2nd October 2022

Driver Information

Driver Name

First Last

Driver Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Driver Email

Driver Mobile

Driver Phone

Driver Dietary Requirements (including food allergies) for lunch and finish

If you wish to be running close to a friend or colleague please let us know who it is

Passenger Information

Passenger One Name

First Last

PassengerOne Dietary Requirements (including food allergies) for lunch and finish

Passenger Two Name

First Last

Passenger Two Dietary Requirements (including food allergies) for lunch and finish

Passenger Three Name

First Last

Passenger Three Dietary Requirements (including food allergies) for lunch and finish

Car Details

Car Make

Car Model

Year of First Registration

Registration Number

Colour

Entry Fee

Entry Fee (Driver and One Passenger including Lunch and Afternoon Tea) - £80.00

Entry Fee for additional passengers - £35.00 per extra passenger

£ Pounds . Pence

Voluntary Donation to our nominated charity Demelza Hospice Care for Children

£ Pounds . Pence

Total (Entry Fee and Donation)

£ Pounds . Pence

Payment of the Entry Fee and Donation via BACS is the preferred method as follows:
Account Name: Blackpalfrey MCK
Sort Code: 60-60-08
Account No.: 02938731
Payment Ref: 'ToK - insert your surname

Privacy

We will publish your names and your vehicle details in the Entry List and Final Running Order and use the information to provide you with any necessary updates for the Tour of Kent 2022. Your email address will be passed to our Official Photographer who will contact you with details of photographs taken on the day. Following the event this entry form and other records will be destroyed. The Blackpalfrey Motor Club of Kent's Privacy Notice can be viewed in full on the club website at www.blackpalfrey.co.uk

I wish to receive details of future Tours of Kent - your email address will only be retained for this purpose only

I do not wish to receive further details of future Tours of Kent

Declaration

In submitting this form I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence.
In submitting this form I further declare that the use of the vehicle hereby entered will be covered by insurance as required by the law which is valid for such part of this event as shall take place on roads as defined by the law.
I declare that the information given on this form is correct.