Hylton Gott Volvo Centenary Stages 2015 Internet Entry Form

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

Hylton Gott Volvo Centenary Stages

Snetterton - 16th August 2015


Entries Close for seeding on 8th August 2015 at 21:00

 

Entries Secretary: Nicola Mansell
4 Mount Pleasant Road
Grindleford
Hope Valley
S32 2JE

Telephone: 01433 631544 / 07795 026963
Email: entries@centenary-stages.co.uk

 

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

Welcome to the 2015 Hylton Gott Volvo Centenary Stages 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. There are then two ways to pay
    1. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. The details are:-
       
      Bank Yorkshire Bank
      Sort Code 05-08-18
      Account No. 33223113
      Account Name Sheffield & Hallamshire Motor Club
      Reference Driver's full name.

    2. You can send a cheque, made payable to 'Sheffield & Hallamshire Motor Club Ltd' to the Entries Secretary at the address above.

  4. Within 24-48 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@centenary-stages.co.uk
  6. 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
Whom should we send Finals, Results and your allocation of passes to?
How would you like to receive Finals and Results?
Please note, your allocation of 6 passes per entry are paper tickets, and will be posted to you.
Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Novice
(Defined as being in your first year of stage rallying)
Driver Publicity

Please complete this section as thoroughly as possible - it will greatly assist our commentator.

Hobbies
Married? Name? How Long?
Number of Children? Names?
How Long Rallying? Previous cars?
Notable Results
Any other information
Driver's Parent or Guardian (under 18 only)
Name
Address (if different)
Post Code
Telephone Number
Relationship
Co-Driver
Full Name
Address
Post Code
Home Town
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Novice
(Defined as being in your first year of stage rallying)
Co-Driver Publicity

Please complete this section as thoroughly as possible - it will greatly assist our commentator.

Hobbies
Married? Name? How Long?
Number of Children? Names?
How Long Rallying? Previous cars?
Notable Results
Any other information
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
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
Roadrunner Phoenix Awards ANEMMC Stage Rally Championship
Crew Members Registered
Alexander Calder Financial EMAMC Single Venue Stage Rally Championship
Crew Members Registered
Person to be contacted in case of serious accident to Driver
Name
Address
Post Code
Telephone 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
Telephone Number
Relationship
Will this person be attending the event?
Seeding - Past Performance on Rallies
Event Name and ClubYearClass PositionCompetition No.Overall PositionNo of Starters
Seeding - Competitor Opinion
Out of 100 entries, where do you think you should be seeded?
Scrutineering
When would you prefer to scrutineer? Saturday - 5:30pm-8pm
Sunday - 6:30am onwards
Fees - see above for how to pay
Entry Fee £
Club Membership £
Donation to the Marshals Draw£
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

Overnight Camping

Overnight camping is available on Saturday night only.
Please select your required option, or 'none' if camping is not required.

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 and competent to take part in the event. I understand that motorsport is dangerous and accidents causing death, injury, disability and property damage can and do happen. I understand that these risks may give rise to my suffering personal injury or other loss and I acknowledge and accept these risks. ‘In consideration of the acceptance of this entry I agree that neither any one of or any combination of the MSA and its associated clubs, the organisers, the track owners or other occupiers, the promoters and their respective officers, servants, representatives and agents (the “Parties”) shall have any liability for loss or damage which may be sustained or incurred by me as a result of participation in the Event. Nothing in this clause is intended to or shall be deemed to exclude or limit liability for death or personal injury. To the fullest extent permitted by law I agree to indemnify and hold harmless each of the Parties in respect of any loss or damage whatsoever and howsoever arising from my participation in the Event. 'I declare that to the best of my belief the driver(s) possess(es) the standard of competence necessary for an event of the type to which this entry relates and that the vehicle entered is suitable and roadworthy for the event having regard to the course and the speeds which will be reached'. ‘I understand that should I at the time of this event be suffering from any disability whether permanent or temporary which is likely to affect prejudicially my normal control of my vehicle, I may not take part unless I have declared such disability to the ASN which has, following such declaration, issued a licence which permits me to do so.’ ‘I have read and fully understood the Procedure for Control of Drugs and Alcohol as contained in the Competitors’ and Officials’ Yearbook Regulations H39, D35.1, G15.1.4 and have also fully familiarised myself with the information on the web sites referred to (www.ukad.org.uk and www.wada-ama.org) in particular the UK Anti Doping Rules which have been adopted by the MSA (as amended). Further, if I am counter-signing as the Parent or Guardian of a minor then in addition to the deemed consent to the testing of that minor (UKAD Code Art 5.6.2) I hereby confirm that I give such consent for the minor concerned to be so tested. ‘I hereby agree to abide by the MSA Child Protection Policy and Guidelines and the National Sporting Code of Conduct.’

Any Indemnity and/or Declaration signed by a person under the age of 18, must be countersigned by his/her parent or guardian, to confirm that the entry is made with his/her consent, and whose full name and address must be stated below. If I am the Parent or Guardian of the driver ‘I understand that I shall have the right to be present during any procedure being carried out under the Supplementary Regulations issued for this event and the General Regulations of the MSA.’ As the Parent/Guardian ‘I confirm that I have acquainted myself and the minor with the MSA General Regulations, agree to pay any appropriate charges and fees pursuant to those Regulations (to include any appendices thereto) and hereby agree to be bound by those Regulations and submit myself without reserve to the consequences resulting from those Regulations (and any subsequent alteration thereof). Further, I agree to pay as liquidated damages any fines imposed upon me up to the maxima set out in Part 3, Appendix 1.’ Note: Where the Parent is not present there must be a Guardian who must produce a written and signed authorisation from the Parent/Guardian to act as their representative.

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