2010 APPLICATION FORM
 
 
Team Name*
This will be your call sign during the Rally - so think carefully, you will be known as this...
 
 
Tell us why you should join us on the 2010 Dumball in 300 characters or less!*
Describe your motor, your fancy dress theme, the lot. Inspire us!
     
 
       
 
Lead Team Member
Name*
 
 
Date of Birth* (Day/Month/Year)
  /   /  
 
MALE   FEMALE
 
Mobile Telephone Number* 
 
 

THIS PERSON WILL BE RESPONSIBLE FOR COLLECTING PAYMENT & WILL BE OUR MAIN POINT OF CONTACT
 
 
 

 
 
Address
House Name or Number*
 
Road
 
Town or City
 
County
 
Post Code*
 
 
E-mail Address*
 
 
       
 
 
Team Member 2
Name*
 
Date of Birth* (Day/Month/Year)
  /   /   
 
MALE   FEMALE
 
Mobile Telephone Number*
 
 
E-mail Address*
 
 

 
Address
House Name or Number*
 
Road
 
Town or City
 
County
 
Post Code*
 
 

 

 

 
 
 
Team Member 3 If only 2 in your team, leave blank
Name
 
 
Date of Birth (Day/Month/Year)
  /   /  
 
MALE   FEMALE
 
Mobile Telephone Number
 
 
E-mail Address
 
 

 
Address
House Name or Number
 
Road
 
Town or City
 
County
 
Post Code
 
 
 
     
 
 
IMPORTANT
Click here to read the terms and conditions
 
  
We have read the terms and conditions*
By submitting this form we agree that our place is not guaranteed until we have received a confirmation e-mail.
CONFIRMATION E-MAILS WILL BE SENT OUT IN JANUARY
 

*COMPULSORY FIELDS