2010 GINETTA OWNERS CLUB SPEED CHAMPIONSHIP

REGISTRATION FORM

  Membership Number:		
  Name:		
  Address:		

		
		
  Telephone Number:		
  Mobile Telephone Number:		
  E-mail:		
  Ginetta Model:		
  Registration Number:		
  Engine and Capacity:		
  Class Entered:		
  Brief Specification		
     Including modifications:		

		

		

				Signed:

				Date:

Form to be returned to Nick Stephens, 47 New Street, Cubbington, Leamington Spa CV32 7LA
       with a cheque for £25 made payable to "Ginetta Owners Club"	
								by 31st January 2010