Real Name:

Gaming Name:

Age:

State or Providence:

Country:

Email Address:

Hours spent online per week:

If you have been in a clan before, please list all of the
ones you were in and the reason why you left them:


Do you play Grid Racing?: ------------------ Yes No

Do you play the Derby part of Grid?: ------------------ Yes No

What type of Internet Connection do you have?: ------------------ 56k DSL Cable T1 or Better

Do you have Headset and Microphone?: ------------------ Yes No Will get one

List the other online Games you Play?:


Please explain a little about yourself, when you are normally online,
How long you have been playing the Games we play and anything
else you would like to inform us:


Would you help pay for a server?: ------------------ Yes No

And finally....
Where did you hear about Blood & Fire?: