ASWMC 2012 Championship Registration Form
NAME:
DOB (if Under 21):
House Name/Number:
Street:
Town:
County:
Post Code:
Tel No: Home:
Mobile:
Email Address**
**Please ensure this is completed as many clubs now send their regulations via email.
ASWMC Newsletter:
Club:
Signature:   DATE:
CHAMPIONSHIPS: Please tick boxes of ALL Championships that you wish to enter.
Please ensure that ALL information is entered as failure to do so may lead to points being incorrectly allocated.
STAGE RALLY: LOOSE
£15.00
STAGE RALLY: SEALED
£15.00
CLASSIC RALLY:
  £10.00
OPEN NAV RALLY:
  £10.00
NOVICE NAV RALLY:
  £10.00
HILLCLIMB:
£14.00
ALL-ROUNDERS GROUPS
RALLIES A
HILLCLIMB & SPRINT B
AUTOCROSS C
AUTOTEST D
TRIALS E
Select 2 championships from different groups
SPRINT:
£14.00
AUTOCROSS:
£10.00
JUNIOR AUTOCROSS:
  FOC
AUTOTEST:
FOC
SPORTING TRIAL:
£10.00
CLASSIC TRIAL:
  £10.00
CAR TRIAL:
  FOC
ALL-ROUNDERS:
  See Note:1
UNDER 21’s:
  See Note:1
Note:1 There is no charge for registration to the All-Rounders or Under 21’s Championships, but competitors must pay the registration fee(s) where applicable for the individual Championships they are competing in.
TOTAL AMOUNT ENCLOSED: £
PLEASE MAKE CHEQUES PAYABLE TO "ASWMC" AND SEND TO
PAM HARTILL, 17 ST LEONARDS, BODMIN, CORNWALL, PL31 1LA
DATE RECEIVED:
 
2012 REG No:
 
YR BOOK & CARD SENT: