Tom's Winter RallyX Logo
Registration Form
Registrations close at 6:00 PM the day before the race.
  1. Complete all Entrant, Vehicle, and Driver's License Information below, including Owner's Permission and Minor's Permission if Required.
  2. Agree to the waiver form by checking the checkbox.
  3. Click the Submit button at the bottom of the form.
  4. Send fees via etransfer to winterrallyx@gmail.com
  5. On race day, BRING YOUR DRIVERS LICENSE & OWNERSHIP. Tech inspections will be done prior to the drivers meeting.
Round #:
Event Date:
Entrant Information
Full Driver Name:
Email Address:
Address:
City:
Province:
Phone #:
Date Of Birth:
Vehicle Information
Make:
Model:
Year:
Colour:
Plate #:
Province:
Displacement:
Drivetrain:
Driver's License Information
Province:
Number:
Expiry Date:
Participant Disclaimer
I have read the Winter RallyX Rules, General Information, and all other regulations in effect for this event and agree to abide by and be bound by such rules and regulations. I further agree to ensure that the drivers nominated by me and all crew members are similarly acquainted with these rules and regulations and agree to abide by and be bound by such rules and regulations. The entrant, in signing this entry form and agreement and in consideration of the right to enter and compete in the event, agrees to participate in the event at his / her own risk. The entrant further agrees that he / she, the drivers, and all crew members shall execute a release agreement (waiver) prior to their admission to the event. If an entrant or driver is under the legal age of majority, this form must be countersigned by the appropriate parent or guardian.

I have read and agree to the Terms and Conditions Agreement
Owner's Permission: (If the Entrant is not the owner of the vehicle being used - If running the Rental, click Accept)

I declare I have been granted permission of the vehicle owner to use this vehicle for the duration of this event.
Owner Name:
Parental Consent for Minor Entrants: (If the Entrant is Under 18 Years Of Age)

I declare I have been granted permission for the Entrant to compete in this event.
Parent / Guardian Name: