PMSC 2022 Presidents Prize Car Rally Entry Form
This is the entry form or a navigational rally on October 22, 2022.
In an effort to make the rally as contactless as possible 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 driver's licence, ownership  or insurance information but you must complete the self declaration stating they are valid. We will ask you to show them at the event.
The entry fee is $40.00 for the rally ($30 for PMSC members). You can send an Interac transfer to pete.gulliver@nexicom.net to submit your payment. Please include "Presidents Prize" and the driver's name in the message for the payment. If you can't attend you will get a full refund.
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Class *
Driver name *
Driver street address *
Driver city & province *
Driver postal code *
Driver Club *
Driver Mobile Phone *
Driver email address *
Driver Emergency Contact Name *
Driver Emergency Contact Phone *
Driver self-declaration *
The electronic waiver can be found here: https://pmsc.speedwaiver.com/cdqmk
Required
Driver declaration for other vehicle occupants *
Please contact the organizers by email at pete.gulliver@nexicom.net for details on which forms to complete.
Navigator  name *
Navigator street address *
Navigator city & province *
Navigator postal code *
Navigator Club *
Navigator Mobile Phone *
Navigator email address *
Navigator Emergency Contact Name *
Navigator Emergency Contact Phone *
Navigator self-declaration *
The electronic waiver can be found here: https://pmsc.speedwaiver.com/cdqmk
Required
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
Entry fee *
Entry fees may be paid by Interac transfer to pete.gulliver@nexicom.net
Required
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