CREATIVE MINDS

Pre Registration Form

This is a pre registration form to book your place in the Scatter rally U.K 2016 Event. All information entered now, can be edited prior to taking part in this event to allow any changes in circumstance. This does not guarantee you a place in this event as spaces are limited.

* Indicates required field

MAIN DRIVER:

*Full name:

*Mobile number:

*Address Line 1:

*City:

*Post code:

*D.O.B:

*UK Driving License:

VEHICLE DETAILS:

*Make:

*Model:

*Reg:

*Type of vehicle:

*Does this vehicle have the required m.o.t and tax to be used on a U.K road?

SHARED DRIVER:

Full name:

Address Line 1:

City:

Post code:

D.O.B:

UK Driving License:

Number of passengers:

*Does the main driver have the required insurance to drive the above vehicle on a U.K Road?

CREATIVE MINDS

Creative Minds

Black Belt Recognition

Thirteen

Black Belt - The game

Pre Registration Form

MAIN DRIVER:

VEHICLE DETAILS:

SHARED DRIVER:

Tickets on sale 22nd Feb

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