HRSR Membership Application

Please return this form to the Treasurer, as below

APPLICATION FOR REGISTRATION AS A RACING OR NON-RACING MEMBER FOR 2021


RACING MEMBER MEMBER IN 2020 Number used......
NON-RACE MEMBER IN 2020..Y or N

PERSONAL DETAILS
NAME………………………………………….DATE OF BIRTH……………………….
ADDRESS…………………………………………………………………………………………………………………………………………………………………………………………………………………………………… POST CODE……………………………
TEL. HOME…………………………… WORK ………………………………….
MOBILE……………………………….. E-MAIL…………………………………….
GDPR: Please indicate (tick box) consent for HRSR to keep the information on this page on file. This will only be used by HRSR or HSCC for club purposes and will not be given to third parties. The consent may be withdrawn at anytime by notification to HRSR at the address below.

VEHICLE DETAILS
MAKE………………………….MODEL……………………………………YEAR…….
CLASS………………CAPACITY……………………cc.. WEIGHT…………………kgs
DOES THE CAR CONFORM TO FIA APPENDIX K REGULATIONS……..….YES/NO...
IF YES, DOES THE VEHICLE HAVE FIA ISSUED PAPERS……………..… ..YES/NO…
IF NO, DOES THE VEHICLE HAVE AN HRSR/HSCC VIF……………………YES/NO...
I WISH TO APPLY FOR MEMBERSHIP OF THE HRSR FOR 2021.
HRSR MEMBERSHIP £ Free for 2021
HRSR CHAMPIONSHIP REGISTRATION (per car) £ Free for 2021
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TOTAL (Cheques payable to Historic Racing Saloon Register or HRSR) £Free
Payment can be made by transfer from your bank to TSB Bank plc. Sort Code: 30-95-48. Acc. No.: 00168519.
Please ensure your payment reference includes your name.
WAS YOUR MSA COMPETITION LICENCE ENDORSED IN 2020…………………
IF YES, PLEASE SUPPLY DETAILS……………………………………………………
The committee of the HRSR has the right to refuse or suspend membership.
SIGNED………………………………………………. DATE…………………………
Please return to: Peter Wray, Little Oaks, Mill Lane, Seaton Ross, York, YO42 4NE. Tel.: 01759 319106