Grizedale Stages Rally 2016 Internet Entry Form

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

Entries Close: 18th November 2016. Entries are limited to 80, on a "first come, first served basis", with the final 5 places at the discretion of the organisers. There are NO reserved places for any championships.

Entries Secretary: Sarah Moore
Holme Lea
Bankfield
Beckermet
Cumbria
CA21 2YG
Telephone 01946 841332
e-mail: entry2016@grizedalestages.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 2016 Hippo Motor Group Grizedale Stages Rally 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. If the driver or navigator are under 18 years of age, a paper copy of the entry form should be downloaded and signed by a parent or guardian, and sent to the Entries Secretary prior to the event.
  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. Arrange for your bank to pay the entry fee into our account, if you have telephone or Internet banking. We can also accept entries by Paypal (credit / debit card). If you wish to use this option, please write 'Paypal' in the payment method box and follow the online instructions once you have entered the rally (please note that payment by Paypal will incur a fee). If you don't have telephone or Internet banking, send a cheque to the Entries Secretary, above.
    Bank NatWest
    Sort Code 01-04-66
    Account No. 80164420
    Account Name Grizedale Stages Rally
    Reference Driver's full name.
  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. Please note, your entry will NOT be confirmed until we have received payment from you. 
  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 entry2016@grizedalestages.co.uk

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
Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
Issuing Authority : MSA / other (state)
E-Mail Address
Club
Date of Birth (if under 18) Note SR 8.4 (Competitors under 18 yrs old must submit to the entries secretary a hard copy of the entry form, signed by their parent or guardian, before the event)
Co-Driver
Full Name
Address
Post Code
Telephone Number
Mobile Number
Competition Licence Number
Issuing Authority: MSA / other (state)
E-Mail Address
Club
Date of Birth (if under 18) Note SR 8.4 (Competitors under 18 yrs old must submit to the entries secretary a hard copy of the entry form, signed by their parent or guardian, before the event)
Car
Make
Model
Colour
Registration Number
Engine Capacity
Year
Forced Induction
Four Wheel Drive
Class
In Car Camera Request
Management Car Details
Make
Model
Colour
Registration Number
Contact Name
Contact Number
Sponsor/s
Sponsor Name (Note: this sponsor does not need an entrant's licence)
Championships
ANCC Stage Rally Championship 2016 - Permit No. 66/2016
Crew Members Registered
S G Petch ANECCC Stage Rally Championship 2016 - Permit No. 11/2016
Crew Members Registered
Five of Clubs Championship 2016 - Permit No. 43/2016
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 ClubYearType i.e Nat A / Nat BSurface - loose / tarmac / forestOverall PositionNo of Starters
Seeding - Competitor Opinion
Out of 80 entries, where do you think you should be seeded?
Scrutineering
When would you prefer to scrutineer? Friday 25th November 1600hrs - 2000hrs (Skelwith Fold, Nr Ambleside)
Saturday 26th November 0700hrs - 1000hrs (Skelwith Fold, Nr Ambleside)
Fees - see above for how to pay
Entry Fee £
Club Membership £
Insurance £
Management Pack and Plate see SR15.3 (optional)£
Total Money to be sent£
Payment Method and Details

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.

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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