North Essex Centre – Rally Slip		North Essex Centre – Rally Slip
Rally Name and No:	Rally                  No.	Rally Name:	Rally                  No.
Date:		Date:
Surname:		Surname:
First Names:		First Names:
Address:		Address:
Telephone No:		Telephone No:
E-Mail Address:		E-Mail Address:
Centre:		Centre:
Membership No:		Membership No:
Car Registration:		Car Registration:
Adults:		Adults:
Teenagers:	No.                                 age(s)	Teenagers:	No.                                 age(s)
Children:	No.                                age(s)	Children:	No.                                age(s)
Estimated Arrival:	day                           am/pm	Estimated Arrival:	day                           am/pm
Duration of Stay:	nights	Duration of Stay:	nights
Organised                          Event/Food:	Tickets Required	Organised                           Event/Food:	Tickets Required
Rallies Attended:	First ever, 2, 3, 4, 5, over 5	Rallies Attended:	First ever, 2, 3, 4, 5, over 5
Notes:		Notes:
Caravan/Motorhome:		Caravan/Motorhome:
Overall Length:		Overall Length:
Twin axle      yes/ no		Twin axle      yes/ no
I accept responsibility for expenses incurred on my behalf Signed:  ………………………………………….		I accept responsibility for expenses incurred on my behalf Signed:  ………………………………………….

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