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Merrills Motor Services SMC Stages 2014 Internet Entry Form

Entries to this event are now closed and this page is for record only

Entries Close for seeding on 14th March 2014 at 23.59.

Entries Secretary - John Coulson, 28 Kingston Drive, Flixton, Manchester, M41 9FG. (H) 0161 748 2756 (M) 07779 492 258 (E) entries@smcstages.co.uk

Held under the General Regulations of the Motor Sports Association (incorporating the International Sporting Code of the FISA) and the Supplementary Regulations

Welcome to the SMC Stages 2013 Online Entry system. Please follow the steps below to enter the rally.

  1. Complete all the fields in the form below. The fields with red backgrounds are mandatory.
  2. Once you have hit the "Enter the Rally" button at the end you will receive an automated response confirming we have received your entry form.
  3. The entry fee is £225 up to 7th March 2014 payable either in full or in two instalments of £112.50, one cheque to be dated currently and the second to be dated 7th March 2014, after the 7th March 2014 the entry fee is payable in full only. Paypal will have a 4% surcharge.
  4. Within 24 hours of us receiving the payment for your entry you should receive an e-mail confirming your entry from the Entries Secretary. NOTE: WITHOUT PAYMENT YOUR ENTRY WILL NOT BE VALID.
  5. If you don't receive a response within 3 days of the expected payment date, or if you have any other questions, please e-mail entries@smcstages.co.uk

 For payment, please either pay via PayPal after clicking on Submit at the end of this form, or send a cheqeu payable to "Stockport 061 Motor Club" to address above.

All the fields with a red background must be filled in, or you will not be able to continue. Please put TBA in any red field which you do not know the details for.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
How would you like to receive Finals and Results?
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Co-Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Car
Make
Model
Colour
Registration Number
Engine Capacity
Year
Forced Induction
Four Wheel Drive
Class
In Car Camera Request
Service Vehicle
Make
Model
Colour
Registration Number
Contact Name
Contact Number
Ancillary Vehicle
Make
Model
Colour
Registration Number
Contact Name
Contact Number
Sponsor
Sponsor Name (Note: this sponsor does not need an entrant's licence.
If you have an entrant with an entrant's licence,
please give details later.
Championships
Association of Northern Car Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Association of North Western Car Clubs
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
SD(34) Motorsport Group
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Person to be contacted in case of serious accident to Driver
Name
Address
Post Code
Mobile Number
Relationship
Will this person be attending the event?
Person to be contacted in case of serious accident to Co-Driver
Name
Address
Post Code
Mobile Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies
Event Name and ClubYearTypeSurfaceOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 75 entries, where do you think you should be seeded?
Fees - see above for how to pay
Entry Fee £
Club Membership £
Marshal Fund£
Total Money to be sent£
Payment Method and Details
Entrant (if applicable and not driver)
Name
Address
Post Code
Telephone Number
Nationality
Competition Licence Number
Competition Licence Issuer
Marshal Details
Name
Address
Post Code
Telephone Number
Mobile Number
Email Address
Experience
Comments
Anything else you'd like to tell us

The details on this form will be held on computer in order to be used for the administration of this event. They will also be used to send you information about future events organised by this club, unless you untick this box to indicate you do not wish to receive information on further events.
The details on this form may also be passed on to other motorsport organisations, unless you untick this box to indicate you do not wish these details passed on.

Remember your entry is subject to receipt of the correct entry fee. An automated acknowledgement is NOT confirmation of entry. Rejected entries and entries held in abeyance will be informed by e-mail to the address(es) given above.

By clicking on the 'Enter the Rally' button below you agree to the following: 'I declare that I have been given the opportunity to read the General Regulations of the Motor Sports Association and, if any, the Supplementary Regulations for this event and agree to be bound by them. I declare that I am physically and mentally fit to take part in the event and I am competent to do so. I acknowledge that I understand the nature and type of the competition and the potential risk inherent with motor sport and agree to accept that risk. Further, I understand that all persons having any connection with the promotion and/or organisation and/or conduct of the event are insured against loss or injury caused through their negligence.'

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