2017 Milltek Sport Volkswagen Racing Cup Championship Registration Form

2017 Milltek Sport Volkswagen Racing Cup Championship Registration Form
Driver Details
Full Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Telephone
Mobile *
Email Address *
Date of Birth *
01/01/2016
Nationality *
Next of Kin
Name *

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Contact Number *
Competition Details For Drivers
MSA Licence Number *
Grade of Licence *
Preferred Competition Number *
Vehicle Details
Model *
Year of Build *
CC *
Turbo *
Delete as appropriate
Car Colour *
The Main Colour
Transponder Number *
Team / Entrant Details (if different to drivers details)
Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Entrants Licence Number
Team Contact Name
Telephone
Email
2017 Milltek Sport Volkswagen Racing Cup Championship Registration

£400 plus VAT

(This price is available up until 31/01/2017 Price after this date will be £750 plus VAT)

In accordance with rule 1.4 - if a driver withdraws from the championship for whatever reason, regardless of circumstances at any point before the final event of the championship, NO REFUND of registration fee already paid will be made.

Please arrange your payment by one of the following two methods:

1. Cheques payable to Maximum Motorsport Limited.
Maximum Motorsport Limited, Dunton house
Little hay lane
Little hay
Staffordshire
WS14 0QD

2. BACS Payment.
Bank: HSBC
Account Name: Maximum Motorsport Limited
Sort Code: 40-43-28
Account Number: 7202 2311

No championship registration is confirmed until a cleared payment is received.
By ticking this box you are agreeing that all information on the above form is correct *

Signature
Once submitted you will be diverted to the payment information on the VW Racing Cup website. Please do not close this screen until actioned.

VAT Registration Number: 08027571

Maximum Motorsport Ltd, Dunton house
Little hay lane
Little hay
Staffordshire
WS14 0QD
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