Club Championship 2023 Registration Form

Inverness & District MCC Ltd - Club Championship Registration Form - 2023

The Inverness & District MCC Ltd directors and committee are very grateful for your offer of assistance or to take part in the 2023 Club Championship. Please complete all sections/questions whether you are riding or observing below accurately, with your assistance we can make our event a success!
Full Name*

First NameLast Name
Tick one only*

I wish to ride in the ChampionshipI wish to OBSERVE in the Championship
Tick one only : Transport To Sections*

On FootOn BikeI am a rider, not observing
Rounds you intend Observing at (tick one)*

Round 1 - April 23 - Alvie EstateRound 2 - July 30 - TomchraskyRound 3 - September 17 - CannichAll 3 Rounds aboveNot applicable, I'm a rider.
Observing Experience Level (tick one)*

Regular Observer at National levelRegular Observer at club eventsModerate experienceLimited experienceNo experienceI'm a rider, not an observer
Declaration (tick one)*

OBSERVER: I declare that I will be observing at Club ChampionshipRIDER FOR CHAMPIONSHIP POINTS: I declare that I will be riding in the 2023 Club ChampionshipRIDER FOR NO POINTS: I declare that I will ride the championship but for no points
E-mail
Phone Number
Mobile Number*
Address*

Address Line 1

Address Line 2

Town/CityCounty

Post CodeCountry
Any other information or comments?
Signature (Use cursor to sign): I am a bona fide 2023 member of IDMCC/ITC*

Clear
Date of submission and signature - Thank you for supporting the 2023 Club Championship!

DayMonthYear
Date
Should be Empty:

Inverness & District MCC Ltd - Club Championship Registration Form - 2023