Event

• Choose the events you wish to register for

Entry Details

• Class Expert Novice
• Seed FIA 1 2 3 4 5A 5B 6

Entrant

• First Name
• Last Name
• Address
• City
• Province
• Postal Code
• Phone
• Email

Driver

• First Name
• Last Name
• Address
• City
• Province
• Postal Code
• Phone
• Email
• Club
• Driver's license no.
• License Province
• License Expiry Date
• Competition license no.
• Competition license type CARS National CARS Regional NASA/RA National NASA/RA Regional FIA Permit
• Competition license Expiry

Driver Emergency Information

• Date of Birth
• Health Card Number
• Province of Issue
• Drug Allergies
• Current Medication
• Current Health Conditions
• Emergency Contact Name
• Relationship to Driver
• Emergency Contact Number
• Are they attending the event? No Yes
• Other Relevant Information

Co-Driver

• First Name
• Last Name
• Address
• City
• Province
• Postal Code
• Phone
• Email
• Club
• Competition license no.
• Competition license type CARS National CARS Regional NASA/RA National NASA/RA Regional FIA Permit
• Competition license Expiry

Co-Driver Emergency Information

• Date of Birth
• Health Card Number
• Province of Issue
• Drug Allergies
• Current Medication
• Current Health Conditions
• Emergency Contact Name
• Relationship to Co-Driver
• Emergency Contact Number
• Are they attending the event? No Yes
• Other Relevant Information

Vehicle

• Class Open 4WD Production 4WD Open 2WD Production 2WD Group 5 Exhibition
• Make
• Year
• Model
• Colour
• License plate no.
• License Plate Prov
• License Plate Renewal Date
• Insurance Co
• Insurancy Policy No
• Do you own the vehicle that you will be competing in? No Yes

Service Crew

• Service Crew Contact Name
• Service Crew Contact Email

Payment Information

The Maple Leaf Rally Club accepts the following forms of payment:

• Payment Method
• Cash or Cheque
  Credit Card
  Interac EMT