Rallycross On-line Entry Form

Event Information:

Select Event:

Entrant Information:

First Name:
Last Name:
E-mail Address:
Address:
City:
Prov/State:
Postal/Zip Code:
Telephone #:
Club Affiliation:

Vehicle Information:

Year:
Make:
Model:
Engine Size:
Drive Train:
Tires (Brand/Model):
Tire Size:

Competitor Information:

Class:
Requested Car #:
Is this a shared vehicle?
Are you a new competitor?	Is this your first event? Not sure what to do at the event? Looking to learn more or get some additional 1-on-1 instruction? Say yes and we'll pair you with an experienced instructor to help you out. There's a newbie driver's meeting and course walk so check the schedule and show up early.

I declare that I am aware of the Vehicle Classification rules and the information given is true and complete to the best of my knowledge. It is understood and agreed that the undersigned and the car described above are to participate / compete under the provisions of the appropriate sections of the current ARMS Handbook and the event's Supplementary Regulations. The Entrant agrees to ensure that he/she, the driver, the owner,and all crew members understand and sign the waiver for this event. This entry is not valid unless the RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT form for this event has been signed by all registered herein (driver, owner, and all crew members).

Moncton Motor Sport Club