*First Name

*Last Name

Membership Number (leave blank if not a member)

BMW Club:

*Phone/Mobile

*Email

*Residential Address

*Suburb *State *Postcode

CAMS L2S Licence Number Expiry Date

Car

*Make *Model

*Year Series (Exx/Fxx/Gxx)

This car will be shared with another driver

Championship Class

Preferred Car Numbers

Best Time at Track (min : sec – if known)

Disclaimer & Conditions of Entry

I certify that I have read and accept the conditions of, and acknowledge the risks arising from, attending or participating in the event and being provided with the event services by AASA/CAMS/ARDC and Associated Entities

I certify that I am 18 years or over

OR

For persons under the age of 18 years, a signed statutory declaration detailing the activity, participant and details of parent/guardian must be emailed to motorsport@bmwclubnsw.asn.au for the entry to be processed