Circuit Rally Awards Registration Form

Circuit Rally Awards Registration Form
Event Address: CASA Hotel, Lockoford Lane, Chesterfield S41 7JB (Barcelona Suite)
Event Date: 1st June 2024
Event Time: Arrival 19.00, Dinner 19.30, Carriages 00.00
Contact us at registrar@circuitrally.co.uk
Name*

First NameLast Name
Mobile Number*
Email*
example@example.com
Please add the names of those in your party*
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Menu Choices*

	Roasted Red Pepper & Tomato Soup (V/VG)	Chicken, Pork & Tarragon Terrine (GF)	Beef Bourguignon	Fillet of Salmon (GF)	Sun Blush Tomato, Mozarella & Pesto Risotto (V/GF))	Home-Made Sticky Toffee Pudding (V)	Blood Orange Posset (V/GF)
Guest 1
Guest 2
Guest 3
Guest 4
Guest 5
Guest 6
Guest 7
Guest 8
Guest 9
Guest 10

Allergies / Restrictions - please list below the name and any specific allergies / restrictions, for us to pass on to CASA Hotels
Seating Arrangements - please add below anyone that you would "like" to sit with, we will try our best to facilitate this, but can't promise!
If you're an award winner, please upload a photo a photo of your car on a championship round

Cancelof
Tickets are priced at £48 per person, please ensure that you arrange a transfer for the required amount to the below bank details:

Account Name: Dukeries MC No2 Account
Account Sort Code: 08-92-99
Account Number: 63099074
Reference: First Name and Last Name
Should be Empty: