P3 Solutions Benarkin Officials Registration
Date: 16 September
Street Address, Suburb/Town/City State and Post Code
Mobile Phone No:
Are you a licenced CAMS official?
CAMS licence number and Grade
CAMS licence expiry date?
Date of Birth (If under 18 years)
Medical Details (please indicate any allergies, medications you take, etc. This information remains confidential and will be destroyed post event).
Emergency Contact and Phone Number
Event 16 September (Event) Saturday 2017
Set Up Friday 15 September 2017
Pull down Sunday 17 September 2017
Role (Please indicate your preference)
Stage Commander or Asst Stage Commander
Time Control Official
Start Control Official
Flying Finish Control Official
Stop Control Official
Start /Regroup Official
SOS (Club Radio Suppled)
Road Closure ( Club Radio supplied)
Radio Base - Command Centre
If Other - please specify
Other Officials you will be attending with
Type of vehicle you will be attending the event in.
YES - Sedan
YES - 4WD
Other - Ute
NO - travelling with some else
Vehicle Radio on BSCC Club Frequency - Please indicate if you have a radio in your vehicle with BSCCFrequencies
Thank your for Registering to be an Official -
P3 Solutions Benarkin Rally 2017
Brisbane Sporting Car Club
The information contained in this form will be compiled by the - Brisbane Sporting Car Club Ltd into a database. No information will be distributed to any third party. By completing this form I give my consent to this information being stored and used by the Brisbane Sporting Car Club Ltd.
Do Not Fill This Out