2023 Blossom Rally Entry Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This is the entry form for the Blossom navigational car rally on May 6,2023. The rally is the third round of the 2022 Ontario Road Rally Championship.
We'd like you to fill out this entry form before coming to the rally. We've simplified the form so we only capture names and addresses. We are not asking for drivers licence, ownership or insurance information but you must complete the self declaration stating they are valid.
The entry fee is $50.00 for the ORRC portion of the rally or $20 for just the SNATR portion. You can send an Interac transfer to martinl@htl.net, or use this Motorsport Reg link: http://msreg.com/KWRC-BL-23 to pay via credit card. Please include "Blossom" and the driver's name in the message for the payment. If you can't attend you will get a full refund.
Already entered a KWRC rally this year? If none of the information has changed just fill in the class, names and email addresses and we can get the rest from the previous forms.

Class *

ORRC Novice $50

ORRC Expert $50

SNATR Beginner $20

SNATR Experienced $20

Driver name *

Driver street address

Driver city & province

Driver postal code

Driver Club

Driver Mobile Phone

Driver email address *

Navigator name *

Navigator street address

Navigator city & province

Navigator postal code

Navigator Club

Navigator Mobile Phone

Navigator email address *

Driver Emergency Contact Name

Driver Emergency Contact Phone

Navigator Emergency Contact Name

Navigator Emergency Contact Phone

The vehicle is owned by:

Vehicle owner (if not Driver or Navigator)

Vehicle year

Vehicle make

Vehicle model

Vehicle colour

Vehicle Province/State of registration

Driver self-declaration

The Blossom is insured by CARS insurers. The waiver can be pre-printed:

My driver's licence is valid and not expired

The vehicle registration is valid and licence plate has not expired

The vehicle is insured and the insurance has not expired

The vehicle is owned by a team member or if the owner is not a team member I have a permission letter to use it

I will either sign of the event insurance waiver at the start or will bring a pre-printed copy to the start

Navigator self-declaration

The Blossom is insured by CARS insurers. The waiver can be pre-printed:

I will either sign of the event insurance waiver at the start or will bring a pre-printed copy to the start

Entry fee

Entry fees may be paid by Interac transfer to martinl@htl.net or by credit card at http://msreg.com/KWRC-BL-23.

We have paid (or will pay before the event) the amount indicated at the top of the form by Interac transfer

How did you hear about this event?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms