2007 CHAMPIONSHIP REGISTRATION FORM

Complete the form below and return it to AEM.

Your details:

Name _________________________________________________

Postal address __________________________________________

___________________________________ Postcode ___________

Phone (home) ___________________ (work) __________________

mobile ____________________________

email _________________________________________________

Date of birth _________ Occupation _________________________

Car entered:

Year _____ Make & Model _________________________________

Engine capacity _____cc   4WD?   YES   /   NO    Turbo or S/C?  YES   /   NO

I agree to abide by the regulations as set out by AEM for the Biante Trevor Young Championship, any event
regulations and further regulations that may be issued.

Signature _____________________________ Date _____________

 

This completed and signed form may be posted or scanned and emailed back to AEM.

AUTOMOTIVE EVENTS MANAGEMENT
PO Box 1222, Subiaco, Western Australia, 6008
Email: info@classicrally.com.au Tel: 9271 0101