Clubmans Rally Registration Form "*" indicates required fields Select Payment Option* Online Payment Download registration form & cheque payment Cheque Payments Download the Registration Form here Please send completed form with full remittance to the Championship Secretary: Ken Binstead Fyvie, Hollow Street, Great Somerford. Wilts. SN15 5JD. DriverName First Last Address Street Address Address Line 2 City ZIP / Postal Code Email Phone No.HRCR No. HRCR Expiry Date Experience Master Expert Novice See championship regulations for experience definitions25 and under Yes NavigatorName First Last Address Street Address Address Line 2 City ZIP / Postal Code Email Phone No.HRCR No. HRCR Expiry Date Experience Master Expert Novice See championship regulations for experience definitions25 and under Yes Car DetailsYou will not be committed to only using this car on championship eventsCategory Category 1 Pre 1st Jan 1960 Category 1 Post 1st Jan 1960 Category 2 Category 3 Category 4a Category 4b Make* Model* Engine #of cyl & cc* Year of specification* Trip meter: Mechanical Trip Electronic (Brantz etc) Reg No.* Year of Registration* Declaration Download the Championship Regulations hereDeclaration* I agree to comply with the Championship Regulations and confirm that the vehicle entered will be eligible for the championship in accordance with the Championship Regulations. I confirm that I am a fully paid up member of the HRCR, the above details are correct and I agree to the information being held on computer Data Protection I agree DATA PROTECTION ACT/ GENERAL DATA PROTECTION REGULATION: The information declared above will be held on computer for membership administration and HRCR event or championship / series purposes only; including emailing you about Club events and Club newsletter. Please tick to confirm you are happy for us to use your personal data in this mannerRemittancePrice* Crew Registration, driver and navigator - £25.00 Individual Registration, driver or navigator - £15.00 25 and under Remittance Remittance Enclosed Credit CardCard Details Cardholder Name Digital Signature Δ
