Hillclimb and Sprint Association
an MSA recognised club
MSA recognised

COMPETE IN THE HSA CHAMPIONSHIP

Title
First Name:
Surname:
Email Address:
Postal Address:
Line 1
Line 2 (optional)
Town/City
County (optional)
Postcode:
Date of Birth:
(dd/mm/yyyy)
Do you hold a valid road traffic licence?:
Competition licence no:
    Grade:
HSA membership no:

Contact numbers. Please enter at least one of the following:
Home Phone:
Mobile Phone:
Work Phone:

Car Details:
Make:
Year:
Type:
Capacity:
Engine:
Turbocharged   Supercharged   Rotary   Diesel  
Class:

  Please tick the box if you DO NOT need championship stickers for 2017 (i.e. if you still have 2013 - 2016 stickers on your car)  

If you are under 18 please enter guarantor (parent/guardian) details below:
Name:
Address:
Relationship:

I hereby request that I be listed as a competitor in the SBD HSA Speed Championship for 2017. I have applied for the appropriate type and grade of competition licence and I am a member of the HSA. I undertake to abide by the regulations governing the championship and the rules of the Motor Sports Association.
  Please tick the box to confirm.