| RallyX Registration Form | |||||||||
| Event: | NER @ NED (New England Dragway) | Epping, NH | |||||||
| February 23, 2008 | |||||||||
| Driver's name: | |||||||||
| Street | |||||||||
| City: | State: | Zip: | |||||||
| email address: | |||||||||
| phone #: | |||||||||
| SCCA member #: | Expires: | Region: | |||||||
| Vehicle Make: | Model: | Year: | |||||||
| Class: | See www.ner.org/Rally for class listings and descriptions | ||||||||
| ___SR ___SF ___SA ___PR ___PF ___PA ___M2 ___M4 | |||||||||
| SCCA members postmarked by 2/19/07 | $50 | ||||||||
| Non-members postmarked by 2/19/07 | $60 | ||||||||
| After 2/19 and at the gate | $70 | ||||||||
| Make checks payable to NER/SCCA | |||||||||
| Mail this form with check for the appropriate amount to: | |||||||||
| Kathy Moody | |||||||||
| NER @ NED RX | |||||||||
| 40 Dylan Ct | |||||||||
| Whitefield, NH 03598 | |||||||||
| To insure that your registration is received prior to the event, Do not mail after Tuesday, Feb 19th. | |||||||||
| Lunch will be provided and is included in the entry fee. Menu similar to that at Stafford. | |||||||||
| Bring your own drinks (NA of course). | |||||||||
| Inquiries? Contact Kathy Moody [email protected] 603-837-2075 | |||||||||
| In order for any person under the age of 18 to be allowed on the site, a Minor | |||||||||
| Waiver form, MS-2A, must be on file with the Region. If you have not filed one | |||||||||
| and intend on bringing a minor, this must be filled out prior to the event. | |||||||||
| If completing prior to event, be sure it is notarized or signed by a member, prior to arriving. | |||||||||
| More info on waivers: http://www.scca.org/_Filelibrary/File/RallySoloRW.pdf | |||||||||
| *****Waivers must be filed for each calendar year. | |||||||||