LANJEW CAR TRIAL

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LANJEW CAR TRIAL

21 MAY 2023

Email *

DRIVER - FULL NAME

ADDRESS

TEL NUMBER

I am aged over 18 (if under 18 parental consent required)

Yes

Clear selection

I am a member of .....Club

Motorsport UK Licence No

Novice

Yes

Person to be advised in case of a serious accident - Name / Relationship / Contact Number / House No / Postcode

I have a valid Road Traffic Act Drivers Licence

Yes

Clear selection

Passenger - Name

Address

Telephone number

I am aged over 18 (if under 18 parental consent required)

Yes

Clear selection

I am a member of Club

Motorsport UK Licence No

Person to be advised in case of a serious accident - Name / Relationship / Contact Number / house No / Postcode

Vehicle entered Make and Model

Class entered

NTF

SURVEY: Replicas and class trophies: Please select your choice

A: one award for each event

B: one award to cover all events in the year

Carbon Emissions data: Miles - home to venue

Entry fee paid

Bank Transfer £25 A/c Camel Vale MC 30 98 98 A/c No: 38422460

Cheque / Other £26

Submit

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