Airtech Integrity Stages Radio Registration Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Mobile Number * This field is required.

4

MSUK Licence Grade* This field is required.

Registered Marshal

Grade 2 Radio Marshal

Grade 1 Rally Marshal

Not Yet Registered

5

MSUK Licence Number * This field is required.if not registered, please type 0000

7

Radio Call Sign * This field is required.

Main Car Set Call Sign

Handheld Radio Call Sign If Applicable

8

Do You Have The Following Kit ?* This field is required.Please tick all that apply

SMMC Channels

SMMC Whip

SMMC Mast

MSUK Mast

Red Flag

9

Do You Have A 4x4* This field is required.

YESNO

10

Will You Be Double CrewedPlease Name All Persons Who Will Be Attending With You, Otherwise Please Leave Blank

Name 1

Name 2

Name 3

Name 4

11

If You Have Any Requests Or Comments, Please Detail Below