Winner Garage SKODA Wyedean Stages Rally 2016 Internet Entry Form

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

SATURDAY 12TH NOVEMBER 2016

ORGANISED BY THE FOREST OF DEAN MOTOR CLUB LTD

Entries Secretary: Sally Waite

South View
Oldcroft
Lydney
Gloucestershire
GL15 4NL

Tel 01594 560533

mobile 07960220956
E-Mail: wyedeanentry@gmail.com

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 Winner Garage SKODA Wyedean Stages Rally 2016 On-line 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. The easiest and cheapest way to pay is on-line by bank transfer. If you have internet or telephone banking, you can arrange for the fees to be paid directly into our account. 
      Bank Lloyds Bank plc
      Sort Code 30-95-29
      Account No. 00235401
      Account Name Forest of Dean M C Ltd
      Reference Driver's and CoDriver's Surnames
    2. You can send a cheque, made payable to 'Forest of Dean M C Ltd' to the Entries Secretary at the address above. 
    3. 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.

If you do not receive a response within 3 days of the expected bank transfer payment date (or longer if you have paid by cheque), or if you have any other questions, please e-mail wyedeanentry@gmail.com

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

Please provide any missing information or advise any changes by e-mail as soon as you are aware of them and as far as possible prior to arriving at the event.

Document Addressing
E-Mail address for communication
Real Name of this person
Whom should we send Finals and Results to?
Driver
Full Name
Address
Post Code
Home Town (Important for Media)
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Nationality
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 (Important for Media)
Telephone Number
Mobile Number
Competition Licence Number
E-Mail Address
Club
Date of Birth
Nationality
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 / Rotary engine
Four Wheel Drive
Class
In Car Camera Request?
FIA Homologated ? Yes / No
Insurers details if NOT using JELF Scheme 
Insurer & Policy No.
Address.
Championships
Pirelli MSA Welsh Forest Rally Championship 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Jelf Motorsport Welsh Clubmans 2WD Forest Rally Championship 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Restruct Ltd Welsh Mixed Surface Championship 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Brian Dennis Motorsport Welsh Historic Rally Championship 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
HRCR Stage Masters Historic Stage Rally Challenge 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
ASWMC Loose Surface Stage Rally Championship 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
Gwynne Speed Rally Challenge 2016
Crew Members Registered
Driver Championship Registration Number
Co-Driver Championship Registration Number
2016 ANWCC Forest Stage Rally Championship
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
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 information - 3 best results achieved as a driver since 1st January 2013. This information will be checked.
Event Name and ClubYearTypeSurfaceOverall PositionClass Position
Scrutineering
When would you prefer to scrutineer? Friday 11th November 16.00hrs - 20.00hrs
Saturday 12th November 07.00hrs - 09.00hrs
Fees - see above for how to pay
Entry Fee £
Club Membership £
Insurance £
Total Money to be sent£
How will you pay? (Bank Transfer / Cheque)
Entrant (only complete if you hold a 2016 MSA entrants licence)
Name
Address
Post Code
Telephone Number
Competition Licence Number

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 reserve will be informed by e-mail to the address(es) given above.

If you wish to pay by bank tranfer (online banking) payments can be made to Forest of Dean M C Ltd,  Sort Code 30-95-29 account no 00235401. Please enter Driver's and CoDriver's Surnames in the 'Reference' field.

Please provide any missing information or advise any changes by e-mail as soon as you are aware of them and as far as possible prior to arriving at the event.

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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