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BLOCK CAPITALS PLEASE
Entrant's First Name................................... Surname........................................................ Telephone No.....................................
Address...........................................................................................................................................................................................
..............................................................................................................................................Post Code...........................................
Vehicle Make ....................................................................... Vehicle Model.....................................................................................
Reg. No..............................Year..................... Class Entered................................... Auto Jumble Plot..........................................
I agree to present my car in a clean and roadworthy condition and declare that the vehicle is covered by insurance as required by the Road Traffic Act 1960.
Insurance Company.......................................................................Policy No........................................................................
Signed...........................................................................................Dated.............................................................................. |