Mudlark Rally Competitor Signup

If you bookmark this page (with the token) you will be able to update your entry at a later date.

Team Name

or Entrant Name

Driver Information

Driver First Name

Driver Last Name

Driver Cell Phone

Driver Email Address

Driver Address

City

Prov/State

AB/BC/SK/QC/USA etc

Driver Driver's License Number and State/Province

Driver Club Affiliation and Membership No.

CSCC / ERC / WCRA and #123 etc

Driver Emergency Information

Please provide your current emergency contact information with relationship and any critical allergies or medical needs our event staff should be aware of. This information is designed to help you and allow us to contact your family in the event you are incapacitated.

Navigator Information

Navigator First Name

Navigator Last Name

Navigator Cell Phone

Navigator Email Address

Navigator Address

City

Prov/State

AB/BC/SK/QC/USA etc

Navigator Driver's License Number and State/Province

Navigator Club Affiliation and Membership No.

CSCC / ERC / WCRA and #123 etc

Navigator Emergency Information

Entry Information

Car Class

Calculator

Unlimited

Historic

Paper

Novice

A novice crew shall be defined as one in which neither crew member has finished a total of three (3) regional NAVIGATIONAL rallies before the beginning of the current competition year, or where neither crew member has won the regional novice navigational championship. A Novice driver may only be awarded championship points when competing with a Novice navigator and vice-versa.

Will you be attending the Novice School?

Yes

Not required but highly recommended if it is your first TSD!

Car Year

TBD if unknown

Make

Model

Colour

License Plate

Insurance Company/Policy Number

Method of Payment

Interac e-Transfer

Cheque

Cash

BTC

See Supps for details.
Cash must be paid at registration and is ineligible for any early entry draws.

Other

Any other concerns or comments?