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WOMZA
wRS
CHAMPIONSHIP MEMBERSHIP
Select the CHAMPIONSHIP you would like to be a Member of:
Full Name & Surname
E-mail
ID Number
Address
Contact Number
Next of Kin
Contact Number
Competing Capacity
Driver
Navigator
Which Championship would you like to join?
WRS Regional Championship
WRS National Championship
Which Group do you race?
A
B
C
D
OR
SXS
Car Make
Car Model
Drive Train
FWD
RWD
4WD
Other
Engine cc
Colour
Medical Info
Own Medical Aid
Womza Medical Cover
*Own Medical* Supply Medical Aid Name and No
Championship Costs
Application R500 Per Person
Submit
BANKING DETAILS
Banking DetailsĀ
WRC
FNB Montana
Acc No 62864485521
BCode 250655