South East Challenge

Payment is taken by PayPal. You do not need a PayPal account.

Note: If you are not already a 2012 SEMSEC Racing member you will need to apply for racing membership of the club, however by paying the £65 registration fee 2012 SEMSEC racing membership is included offering a saving over separate registration and membership.

Full Name of Registering Driver:
MSA Licence Status.
 MSA Licence No.
Drivers Address:

Postcode:

Email Address:

Telephone:
ENTRANT DETAILS
Entrant Name/Title: MSA Licence No.
Address:

Postcode:

Email Address:

Telephone:
CAR DETAILS:
Class Entered: (as per Championship Regulation 5)
 Transponder Number:
 Formula:
Manufacturer:
 Model:
 Engine:
Engine Capacity:
 Current Competition Number:
  
Steel Bodied: yes No
 Forced Induction: yes No
PERSONAL DETAILS:
Please provide some personal profile details of the driver: Age, marital status,
occupation, business or profession, previous motor sport experience and successes if any:
REGISTRATION FEE
Total fee payable
 £ 35.00

I have read and agree to be bound by the MSA Regulations for the Championship for which I am registering.

Enter the code shown above in the box below.