RALLY TEST

   Henstridge Airfield

ENTRY FORM

Name_______________________________________________________

Address______________________________________________________

_____________________________________________________________

email_________________________________________________________

Telephone_______________________ Car club______________________

Name of Passenger______________________________________________

Make & Model of Car____________________________________________

Engine Capacity______________________Year______________________

I declare that the car is road legal and taxed.

I agree to be bound by the rules of the event and enclose £20.00 entry fee.

Signed_____________________________________________________

Any competitor under 18 must obtain the signature of a parent or guardian below.

Passengers only.

I consent to __________________________________ competing in the Rally test

Signed______________________________Relationship___________________

Cheques to be made out to Salisbury & Shaftesbury Car Club Ltd.

Entries to the event are limited, so to guarantee a start,

please fully complete this form and return it ASAP to

Ted Howles Entries Secretary 125 Harnham Rd Salisbury SP2 8JT

Phone 07740 291022 for more details