Thank you for entering and registering using this RallyX registration. Please fill out all fields.


A) Registration Information for July 12 Hope RallyX. Registration opens June 23 @18:00 & closes July 11 @18:00

Driver`s First Name

Driver`s Last Name

Address

City

Province/State

Postal Code

Phone

Email

Preferred Contact by
- Email
- Phone

Driver`s License Number:

Driver`s License Province/State:

B) Vehicle

Year:

Make:

Model:

Main Colour:

License Plate Number:

License Plate Province/State:

C) Class / Drive Type

Class (see supp regs for details):
- Street Tire
- Traction Tire
- Competition Tire

Drive Type
- 2wd
- 4wd

Novice
- Yes
- No

D) License and Membership Details

2014 Competition License
- day @ $10
- 2014 Year @ $25 (last event, get a day License)
- Already have one

If you have a License, License Number?

Club Membership
- day @ $10
- 2014 Year @ $40
- Already have one

If you are a club member, Club?

E) Entry Fee Details.

Competitor Fee
- Non-Member Competitor: $30.00
- RPM Club Member Competitor: $30.00

Total: (Add up License, membership and entry fee)

Supplementary Regulations
Select all that apply
- I have read and agree to the supp regs at July 12 Supp Regs

F) Comments

Any additional Questions/Comments/Suggestions?


  --  
If you do not receive a confirmation email within 48 hours confirming receipt of your registration form or you have any changes to your information after submitting the registration form, please send an email to [email protected].

 

(C) 2013 West Coast Rally Association