Entry Form - Twin - Natal Off Road Motor Club

Twin-Seater Entry Form

ENTRY FEE

R2000.00 – A – B – FIA
R800.00 – Clubmans
R200.00 – Social Class

Competitors wishing to enter must deposit their money directly into the bank account detailed and proof of payment should be emailed to normc@sai.co.za. Competitors’ name and competition (not licence) number must appear on the proof of payment to ensure that monies are credited to the correct entry.

BANKING DETAILS

ACCOUNT NAME: NATAL OFF ROAD MOTOR CLUB
BANK: ABSA
ACCOUNT NUMBER: 1140171588
BRANCH: CHATTERTON ROAD, SANCTUARY, PIETERMARITZBURG
BRANCH CODE: 632005

CLASS & CAR SECTION

Competition #

Class Entering

Vehicle Make

Vehicle Model

Vehicle CC

What type & model GPS do you use?

DRIVER SECTION

First Name

Last Name

MSA Lic #

NORMC Membership #

ID #

Blood Group

Allegies / Medical Conditions

Phone

Street Address

City

Province

Emergency Contact Name

Emergency Contact Phone

How many people are coming with you?

CO-DRIVER SECTION