Autotest Entry Form – Barcud Motor Club

First Name*

Last Name*

Email*

Date of Birth*

Street Address1*

Street Address2*

City*

Postcode*

County

Country

Phone*

Competition Licence Number*

Class Entered*

Name of Passenger (this person must be from the same household as you, or a previously formed “bubble”)*

Passenger's Competition Licence Number*

Make / Model of Car*

Car Colour*

Are You Sharing The Above Vehicle?*

If Yes, Name of the Other Person (must be from the same household as you, or a previously formed “bubble”)

DECLARATION

In submitting this entry, I am agreeing:-

That I have read the Supplementary Regulations for the event
That the above vehicle, if being shared, will only be driven by one other person, who is from my household
That my passenger will be from my household or “bubble”
That I will comply with all of the Covid-19 regulations that are applicable on the day of the event, and will obey any instructions given to me by any of the event officials