Please accept my entry for the following Internet Table-Top Rally Championships 2004-2005.

I shall forward my entry fees, by cheque 
payable to "R D Crowther" to:
R D Crowther, Longfield, Tudwick Road, Tolleshunt Major, Maldon, Essex, CM9 8LP.
(Please write your Name and Address on the back of the cheque) or

I will pay using PayPal (see form below)

Competitor Full Name


E-mail address
(please be accurate to receive an acknowledgement)


Organisation/Club Represented (optional)


Competitor/Organisation/Club Web Site Address (optional)


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