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(For office use only. Competition No____)

Lackford Engineering MG Midget Challenge – 2011

www.mgmidgetchallenge.co.uk

I wish to register for the above championship in:-

   (Tick Box)

Group A -Fully Modified[   ]

Group B -Race Modified[   ]

Group C - Road Going[   ]

Please write clearly IN CAPITALS

Name___________________________________Tel. Home_______________________________

Address_________________________________Business   _______________________________

________________________________________Mobile     _______________________________

__________________________________________________________________________________

Post Code___________________________

E Mail address _________________________________________

MG Car Club Membership No: ___________________

I enclose my cheque for £100 payable to MIDGET COMPETITION GROUP

DECLARATION:

I confirm that in all respects my car complies with the 2011 Vehicle Class Sports & Technical Regulations and that I agree to abide by the rules of the Lackford Engineering MG Midget Challenge 2011 and not to carry out any act which may damage or bring into disrepute the Championship or the Midget Competition Group.

Signature_____________________Date _____/___/_____

Please indicate below which events you seriously intend to contest. Your input is essential to ensure that our pre-season studies are appropriately focused for strategy and grid formation.

Place an X in the box against the events you intend to do:-

___________________________________________

|       |      |      |      |      |      |       |      |      |       |        |       |

|       |      |      |      |      |      |       |      |      |       |        |       |

Event|  1   |  2  |  3  |  4  |  5  |  6  |  7   |  8  |  9  | 10  |  11  | 12  |

Post this application to the Group Competition Secretary.

Larry Quinn1, Dalwood, Thorpe Bay, Essex.  SS3 8UP

Page No 18 of 18- Issue No 3 – 9.12.10

Published by Midget Competition Group – MG MIDGET CHALLENGE-2011

www.mgmidgetchallenge.co.uk

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