SPEED CHAMPIONSHIP REGISTRATION

Please register me in the 2009 ASEMC Speed Championship. I enclose a cheque for the registration fee of £10.00 payable to ASEMC, and agree to be bound by the Rules of the ASEMC and the ASEMC Speed Championship Regulations 2009.
Name Address
Postcode Club Telephone Number e-mail address

Class Entered
Car Details
Make	Model	CC

Modifications

Signature
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Please fill in this application online, print, re-read, sign and send with appropriate
registration fee to:

Chris Judge. 66 Oliver's Mill, New Ash Green, Kent DA3 8RF

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For co-ordinator’s use

Date rec’d:

Reg. No:

Date Ackn’d: