LEICESTERSHIRE CENTRE BOOKING FORM
No. 1 - COPT OAK - BURNS 22 - 24 January 2010
* Name:
Address:


Post Code:
* Membership No.:
*E-mail:
Phone:
Mobile:
*Centre:
* Is this your First Rally as a Leicestershire Member?	Yes No
* Car Registration:
*No. of Adults:			No. of Teenagers:
No. of Children:			*Ages of Children:*
No. of Social Tickets required:
Extra Information the Marshal might need (eg. Trips, special needs etc.)
*In sending this booking I agree to abide by the Rules of the Leicestershire Centre and pay for any* expenses incurred on my behalf in the case of non-attendance. * I Agree
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